干旱区生态环境知识资源中心(Arid): Does the implementation of a restrictive episiotomy policy for operative deliveries increase the risk of obstetric anal sphincter injury?

Arid

DOI	10.1007/s00404-019-05174-0
	Does the implementation of a restrictive episiotomy policy for operative deliveries increase the risk of obstetric anal sphincter injury?
	Gachon, Bertrand 1; Menard, Carine Fradet 1; Pierre, Fabrice 1; Fritel, Xavier 1,2,3
通讯作者	Gachon, Bertrand
来源期刊	ARCHIVES OF GYNECOLOGY AND OBSTETRICS
ISSN	0932-0067
EISSN	1432-0711
出版年	2019
卷号	300 期号:1 页码:87-94
英文摘要	PurposeOur main objective was to investigate whether the implementation of a restrictive episiotomy policy in operative deliveries changes the incidence of obstetric anal sphincter injury (OASI).MethodsThis is an observational study over an 11-year period in Poitiers University Maternity, France. We included women with vaginal operative deliveries after 34 gestational weeks for singleton births in cephalic presentation. We collected data on the mother and operative delivery characteristics: indication, instrument, epidural analgesia, labor length, episiotomy, OASI, and birthweight. We investigated the changes in the mediolateral episiotomy (MLE) and OASI rates and the association between MLE and OASI. The primary outcome was the evolution of the OASI and MLE rates. The secondary outcome was the occurrence of OASI during operative delivery with or without MLE.ResultsIn total, 2357 operative deliveries were assessed, including 847 vacuum-, 1350 forceps- and 160 spatula-assisted deliveries. Of these, 950 were performed with MLE and 1407 without; 37 OASIs (3.9%) occurred in the MLE group, and 137 (9.7%) in the no-MLE group. Between 2005 and 2015, MLE use decreased from 78.5 to 16.2% and OASI occurrence increased from 3.1 to 12.7%. The increase in OASI occurrence was significant for forceps deliveries, but not for vacuum or spatula deliveries. Operative delivery with MLE was associated with a three times lower OASI occurrence than that without MLE (adjusted OR=0.29, 95% CI [0.20-0.43]).ConclusionsImplementation of a restrictive MLE policy for operative delivery seems to be associated with an increase in OASI incidence with forceps, but not with vacuum.
英文关键词	Obstetric anal sphincter injury Episiotomy Instrumental delivery Perineal trauma Childbirth
类型	Article ; Proceedings Paper
语种	英语
国家	France
开放获取类型	Green Submitted
收录类别	SCI-E
WOS记录号	WOS:000471155100011
WOS关键词	VAGINAL DELIVERY ; MEDIOLATERAL EPISIOTOMY ; INCONTINENCE ; FORCEPS ; TRIAL
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/214374
作者单位	1.La Miletrie Univ Hosp, Dept Obstet & Gynecol, CS90577, 2 Rue Miletrie, F-86021 Poitiers, France; 2.Univ Paris Sud, Gender Sexual & Hlth Team, UMRS 1018, Ctr Res Epidemiol & Populat Hlth CESP,INSERM,U101, Orsay, France; 3.La Miletrie Univ Hosp, INSERM CIC P 1402, Poitiers, France
推荐引用方式 GB/T 7714	Gachon, Bertrand,Menard, Carine Fradet,Pierre, Fabrice,et al. Does the implementation of a restrictive episiotomy policy for operative deliveries increase the risk of obstetric anal sphincter injury?[J],2019,300(1):87-94.
APA	Gachon, Bertrand,Menard, Carine Fradet,Pierre, Fabrice,&Fritel, Xavier.(2019).Does the implementation of a restrictive episiotomy policy for operative deliveries increase the risk of obstetric anal sphincter injury?.ARCHIVES OF GYNECOLOGY AND OBSTETRICS,300(1),87-94.
MLA	Gachon, Bertrand,et al."Does the implementation of a restrictive episiotomy policy for operative deliveries increase the risk of obstetric anal sphincter injury?".ARCHIVES OF GYNECOLOGY AND OBSTETRICS 300.1(2019):87-94.