干旱区生态环境知识资源中心(Arid): Is there still an indication for episiotomy? Results from a French national database analysis

Arid

DOI	10.1002/ijgo.14385
	Is there still an indication for episiotomy? Results from a French national database analysis
	Levaillant, Mathieu; Loury, Charlotte; Venara, Aurelien; Hamel-Broza, Jean-Francois; Legendre, Guillaume
通讯作者	Levaillant, M
来源期刊	INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
ISSN	0020-7292
EISSN	1879-3479
出版年	2023
卷号	160 期号:3 页码:880-885
英文摘要	Objective To assess the link between mediolateral episiotomy and the occurrence of obstetrical anal sphincter injury (OASIS). Methods Data were collected from the national database (PMSI; Programme de Medicalisation des Systemes d'Information). Women between 18 and 50 years old, undergoing a vaginal delivery in France in 2018 were included. The main outcome was factors associated with a higher adjusted OASIS rate after a vaginal delivery. Results Of 623 003 women with a vaginal delivery, 239 949 were primiparous (38.5%), 62 310 experienced mediolateral episiotomy (10.0%) and 7077 had a third- or fourth-degree perineal tear (1.14%). Risk factors for OASIS were primiparity (adjusted odds ratio [OR] 2.97), shoulder dystocia (aOR 2.57), instrumental delivery (aOR 2.81), gestational diabetes (aOR 1.20), and post-term delivery (aOR 1.53). Mediolateral episiotomy increased the occurrence of OASIS for women without an instrumental delivery, either for parous (OR 1.32, 95% confidence interval [CI] 1.07-1.62) or primiparous (OR 1.26, 95% CI 1.13-1.39) women. In contrast, episiotomy among primiparous women with episiotomy and a vacuum or forceps delivery significantly decreased the risk for OASIS (OR 0.62, 95% CI 0.56-0.67). Conclusions The practice of routine episiotomy should be discouraged. Selective mediolateral episiotomy should be considered with extreme caution and mainly for primiparous women during instrumental vaginal delivery. Further randomized trial may confirm such results.
英文关键词	anal sphincter database episiotomy health services administration obstetric injury
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000846487300001
WOS关键词	RISK-FACTORS ; SPHINCTER INJURIES ; PERINEAL TEARS ; MANAGEMENT ; COUNTRIES ; DELIVERY
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/2XILL650/397003
推荐引用方式 GB/T 7714	Levaillant, Mathieu,Loury, Charlotte,Venara, Aurelien,et al. Is there still an indication for episiotomy? Results from a French national database analysis[J],2023,160(3):880-885.
APA	Levaillant, Mathieu,Loury, Charlotte,Venara, Aurelien,Hamel-Broza, Jean-Francois,&Legendre, Guillaume.(2023).Is there still an indication for episiotomy? Results from a French national database analysis.INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS,160(3),880-885.
MLA	Levaillant, Mathieu,et al."Is there still an indication for episiotomy? Results from a French national database analysis".INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 160.3(2023):880-885.