干旱区生态环境知识资源中心(Arid): Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis

Arid

DOI	10.1007/s00192-020-04308-2
	Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis
	Pereira, Glaucia Miranda Varella 1; Hosoume, Renato Sugahara 2; de Castro Monteiro, Marilene Vale 3; Juliato, Cassia Raquel Teatin 1; Brito, Luiz Gustavo Oliveira 1
通讯作者	Brito, Luiz Gustavo Oliveira
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2020
卷号	31 期号:11 页码:2291-2299
英文摘要	Introduction and hypothesis We hypothesized whether a non-episiotomy protocol or administration of selective episiotomy as an intrapartum intervention would modify the incidence of obstetric anal sphincter injuries (OASIS). Methods We registered this systematic review with the PROSPERO database (CRD42018111018). Prospective randomized controlled trials (RCTs) were included from databases until February 2019. The primary outcome was OASIS, and the secondary outcomes were any perineal trauma, duration of the second stage of labor, instrumental delivery, and post-partum hemorrhage. The risk of bias (Cochrane Handbook) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria were used to assess the RCTs. Results A total of 1,833 results (PubMed 650, SCOPUS 1,144, Cochrane Library 33, LILACS 6) were obtained. However, only 2 studies fulfilled the criteria for quantitative analysis and meta-analysis (n = 574). The non-episiotomy arm included two episiotomies (1.7% of deliveries), whereas the selective episiotomy included 33 episiotomies (21.4%). Performance of selective episiotomy demonstrated no difference compared with that of the non-episiotomy group with regard to OASIS (OR = 0.46 [0.15-1.39]; n = 543; I-2 = 0%,p = 0.17), any perineal trauma (OR = 0.90 [0.61-1.33]; I-2 = 0%, n = 546, p = 0.59), instrumental delivery (OR = 1.40 [0.80-2.45]; I-2 = 0%, n = 545, p = 0.24), duration of the second stage of labor (MD = -3.71 [-21.56, 14.14]; I-2 = 72%,n = 546, p = 0.68), perineal pain (MD = 0.59 [0.01-1.17]; I-2 = 0%,p = 0.05), and post-partum hemorrhage (OR = 1.75 [0.87-3.54]; I-2 = 0%,n = 546,p = 0.12). The evaluated studies displayed a low risk of bias in at least four of the seven categories analyzed. GRADE demonstrated a low certainty for severe perineal tears, postpartum hemorrhage, duration of the second stage of labor, and a moderate certainty for any perineal tear. Conclusions There was no significant difference between non-episiotomy and selective episiotomy regarding OASIS. No RCT was able to confirm a benefit of the non-performance of episiotomies in the non-episiotomy arm.
英文关键词	Episiotomy Meta-analysis Perineal trauma Systematic review
类型	Review
语种	英语
国家	Brazil
收录类别	SCI-E
WOS记录号	WOS:000528431900001
WOS关键词	ANAL-SPHINCTER INJURY ; RISK-FACTORS ; MATERNITY ; DELIVERY
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/314812
作者单位	1.State Univ Campinas UNICAMP, Dept Obstet & Gynecol, Rua Alexander Fleming 101, BR-13148254 Campinas, Brazil; 2.Ctr Referencia Saude Mulher Mater RP, Ribeirao Preto, Brazil; 3.Fed Univ Minas Gerais UFMG, Dept Obstet & Gynecol, Belo Horizonte, MG, Brazil
推荐引用方式 GB/T 7714	Pereira, Glaucia Miranda Varella,Hosoume, Renato Sugahara,de Castro Monteiro, Marilene Vale,et al. Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis[J],2020,31(11):2291-2299.
APA	Pereira, Glaucia Miranda Varella,Hosoume, Renato Sugahara,de Castro Monteiro, Marilene Vale,Juliato, Cassia Raquel Teatin,&Brito, Luiz Gustavo Oliveira.(2020).Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis.INTERNATIONAL UROGYNECOLOGY JOURNAL,31(11),2291-2299.
MLA	Pereira, Glaucia Miranda Varella,et al."Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis".INTERNATIONAL UROGYNECOLOGY JOURNAL 31.11(2020):2291-2299.