干旱区生态环境知识资源中心(Arid): A novel classification for evaluating episiotomy practices: application to the Burgundy perinatal network

Arid

DOI	10.1186/s12884-019-2424-2
	A novel classification for evaluating episiotomy practices: application to the Burgundy perinatal network
	Desplanches, Thomas 1,2; Szczepanski, Emilie 1; Cottenet, Jonathan 3,4,5; Semama, Denis 6; Quantin, Catherine 3,4,5,7; Sagot, Paul 1,8
通讯作者	Desplanches, Thomas
来源期刊	BMC PREGNANCY AND CHILDBIRTH
EISSN	1471-2393
出版年	2019
卷号	19 期号:1
英文摘要	Background Though the rate of episiotomy has decreased in France, the overall episiotomy rate was 20% in the 2016 national perinatal survey. We aimed to develop a classification to facilitate the analysis of episiotomy practices and to evaluate whether episiotomy is associated with a reduction in the rate of obstetric anal sphincter injuries (OASIS) for each subgroup. Methods This population-based study included all the deliveries that occurred in the Burgundy Perinatal Network from 2011 to 2016. The main outcome was episiotomy, which was identified thanks to the French Common Classification of Medical Procedures. An ascending hierarchical cluster analysis was performed to build the classification. A clinical audit using the classification was conducted yearly in all obstetric units. The episiotomy rates were described throughout the study period for each subgroup of the classification. The OASIS rates were evaluated by subgroup and the association between mediolateral episiotomy and OASIS was investigated for each subgroup. Results Our analyses included 81,290 pregnant women. The classification comprised 7 subgroups: ((1)) nulliparous single cephalic at term, ((2)) nulliparous single cephalic at term with instrumental delivery, ((3)) multiparous single cephalic at term, ((4)) multiparous single cephalic at term with instrumental delivery, ((5)) all preterm deliveries (< 37 weeks gestation), ((6)) all breech deliveries, ((7)) all multiple deliveries. Episiotomy rates ranged from 6.2% in Group 3 to 40.9% in Group 2. From 2011 to 2016, every group except breech deliveries experienced a significant decrease in episiotomy rates, ranging from - 28.1 to - 61.0%. The prevalence of OASIS was the highest in Groups 2 (3.0%) and 4 (2.2%). Overall OASIS rates did not significantly differ with episiotomy use (P = 0.25). However, we found that the use of episiotomy was associated with a reduction in OASIS rates in Groups 1 and 2 (odds ratio 0.6 [95% CI 0.4-0.9] and 0.4 [0.3-0.5], respectively). This reduction was only observed in Group 4 with forceps delivery (odds ratio 0.4 [0.1-0.9]). Conclusion We developed the first classification for the evaluation of episiotomy practices based on 7 clinically relevant subgroups. This easy-to-use tool can help obstetricians and midwives improve their practices through self-assessment.
英文关键词	Episiotomy Vaginal delivery OASIS Ascending hierarchical classification
类型	Article
语种	英语
国家	France
开放获取类型	gold, Green Published
收录类别	SCI-E
WOS记录号	WOS:000481784400004
WOS关键词	ANAL-SPHINCTER INJURIES ; OPERATIVE VAGINAL DELIVERY ; CROSS-SECTIONAL SURVEY ; MEDIOLATERAL EPISIOTOMY ; PERINEAL TEARS ; RISK-FACTORS ; ROUTINE ; RATES ; REGISTER ; FRANCE
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/2XILL650/214706
作者单位	1.CHRU Dijon, Dept Gynecol Obstet Fetal Med & Infertil, Dijon, France; 2.Paris Descartes Univ, Sorbonne Paris Cite, INSERM,U1153,Epidemiol & Biostat, Obstet Perinatal & Pediat Epidemiol Team,Res Ctr, Paris, France; 3.Dijon Univ Hosp, Serv Biostat & Informat Med DIM, F-21000 Dijon, France; 4.INSERM, CIC 1432, Clin Epidemiol Unit, Dijon, France; 5.Dijon Univ Hosp, Clin Epidemiol Unit, Clin Invest Ctr, Dijon, France; 6.CHRU Dijon, Dijon Univ Hosp, Dept Neonatal Pediat, Dijon, France; 7.Univ Paris Saclay, Inst Pasteur, Biostat Biomath Pharmacoepidemiol & Infect Dis B2, INSERM,UVSQ, Paris, France; 8.Univ Burgundy, Dijon, France
推荐引用方式 GB/T 7714	Desplanches, Thomas,Szczepanski, Emilie,Cottenet, Jonathan,et al. A novel classification for evaluating episiotomy practices: application to the Burgundy perinatal network[J],2019,19(1).
APA	Desplanches, Thomas,Szczepanski, Emilie,Cottenet, Jonathan,Semama, Denis,Quantin, Catherine,&Sagot, Paul.(2019).A novel classification for evaluating episiotomy practices: application to the Burgundy perinatal network.BMC PREGNANCY AND CHILDBIRTH,19(1).
MLA	Desplanches, Thomas,et al."A novel classification for evaluating episiotomy practices: application to the Burgundy perinatal network".BMC PREGNANCY AND CHILDBIRTH 19.1(2019).