干旱区生态环境知识资源中心(Arid): Mediolateral episiotomy and risk of obstetric anal sphincter injuries and adverse neonatal outcomes during operative vaginal delivery in nulliparous women: a propensity-score analysis

Arid

DOI	10.1186/s12884-022-04396-6
	Mediolateral episiotomy and risk of obstetric anal sphincter injuries and adverse neonatal outcomes during operative vaginal delivery in nulliparous women: a propensity-score analysis
	Desplanches, Thomas; Marchand-Martin, Laetitia; Szczepanski, Emilie-Denise; Ruillier, Marie; Cottenet, Jonathan; Semama, Denis; Simon, Emmanuel; Quantin, Catherine; Sagot, Paul
通讯作者	Desplanches, T
来源期刊	BMC PREGNANCY AND CHILDBIRTH
EISSN	1471-2393
出版年	2022
卷号	22 期号:1
英文摘要	Background The potential protective effect of mediolateral episiotomy for obstetrical anal sphincter injuries (OASIs) remains controversial during operative vaginal delivery because of the difficulties to take into account the risk factors and clinical conditions at delivery; in addition, little is known about the potential benefits of mediolateral episiotomy on neonatal outcomes. The objectives were to investigate the associations between mediolateral episiotomy and both OASIs and neonatal outcomes, using propensity scores. Methods We performed a retrospective population-based observational study from a perinatal registry that includes all births in a French region between 2010 and 2017. All nulliparous women with singleton pregnancy delivering by operative vaginal deliveries at 37 weeks gestational age or later were included. Inverse-probability-of-treatment weighting with propensity scores was used to minimize indication bias. OASIs was defined as third and fourth-degree tears according to Royal College of Obstetricians and Gynecologists. Two neonatal outcomes were studied: condition at birth (5-min Apgar score less than 7 and/or umbilical artery pH less than 7.10), and admission to neonatal intensive care unit. Results The study population consisted of 7589 women; 2880 (38.0%) received mediolateral episiotomy. After applying propensity scores, episiotomy was associated with a lower rate of OASIs in forceps/spatula delivery (2.3 vs 6.8%, Risk Ratio (RR) 0.38, 95% Confidence Interval (CI) 0.28-0.52) and in vacuum delivery (1.3 vs 3.4%, RR 0.27, 95% CI 0.20-0.38) as compared with no episiotomy. Mediolateral episiotomy was associated with better condition at birth in case of forceps/spatula delivery (4.5 vs 8.8%, RR 0.56, 95% CI 0.39-0.81). In cases of fetal distress (40.7%), mediolateral episiotomy was associated with better condition of infant at birth in women who delivered by forceps/spatula (4.2 vs 13.5%, RR 0.52, 95% CI 0.31-0.89). No association was found with neonatal unit admission (RR 0.93, 95% CI 0.50-1.74). Conclusions Use of mediolateral episiotomy was associated with a lower rate of OASIs during operative vaginal delivery, and in infants it was associated with better condition at birth following forceps/spatula delivery.
英文关键词	Operative vaginal deliveries Episiotomy Obstetric anal sphincter injuries Adverse neonatal outcomes Propensity score
类型	Article
语种	英语
开放获取类型	gold, Green Published
收录类别	SCI-E
WOS记录号	WOS:000744509600003
WOS关键词	MORBIDITY ; COHORT ; ROUTINE ; HEALTH ; TRENDS
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/2XILL650/376536
推荐引用方式 GB/T 7714	Desplanches, Thomas,Marchand-Martin, Laetitia,Szczepanski, Emilie-Denise,et al. Mediolateral episiotomy and risk of obstetric anal sphincter injuries and adverse neonatal outcomes during operative vaginal delivery in nulliparous women: a propensity-score analysis[J],2022,22(1).
APA	Desplanches, Thomas.,Marchand-Martin, Laetitia.,Szczepanski, Emilie-Denise.,Ruillier, Marie.,Cottenet, Jonathan.,...&Sagot, Paul.(2022).Mediolateral episiotomy and risk of obstetric anal sphincter injuries and adverse neonatal outcomes during operative vaginal delivery in nulliparous women: a propensity-score analysis.BMC PREGNANCY AND CHILDBIRTH,22(1).
MLA	Desplanches, Thomas,et al."Mediolateral episiotomy and risk of obstetric anal sphincter injuries and adverse neonatal outcomes during operative vaginal delivery in nulliparous women: a propensity-score analysis".BMC PREGNANCY AND CHILDBIRTH 22.1(2022).