干旱区生态环境知识资源中心(Arid): Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study

Arid

DOI	10.1080/14767058.2023.2244627
	Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study
	Ragusa, Antonio; Ficarola, Fernando; Svelato, Alessandro; De Luca, Caterina; D'Avino, Sara; Carabaneanu, Alis; Ferrari, Amerigo; Cundari, Gianna Barbara; Angioli, Roberto; Manella, Paolo
通讯作者	Ficarola, F
来源期刊	JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
ISSN	1476-7058
EISSN	1476-4954
出版年	2023
卷号	36 期号:2
英文摘要	Objective: The use of episiotomy during operative vaginal birth (OVB) is rather debated among operators and in literature. It is also important to evaluate the indications for which episiotomy is performed. In fact, the consequences of an episiotomy can be invalidating for patients with long-lasting results. The aim of this study is the evaluation of the role of episiotomy during OVB with the vacuum extractor and its correlation with Obstetric Anal Sphincter Injuries (OASIs). Methods: On of 9165 vaginal births, a total of 498 OVB (5.4%) were enrolled in a longitudinal prospective observational study. The incidence of OASIs was evaluated in our population after OVB performed with the vacuum extractor, during which the execution of episiotomy was performed indicated by clinician in charge. Results: OASIs occurred in 4% of the patients (n = 20). Episiotomy was performed in 39% of them (n = 181). OASIs incidence was 6% (n = 17) in the No Episiotomy and 1.8% (n = 3) in Episiotomy group (p<.001). Performance of episiotomy during OVB determined a protective effect against OASIs (p = 0.025 in full cohort and p = 0.013 in the primiparous group). An expulsive phase under one hour was an almost significant protective factor (p = 0.052). Conclusions: The use of episiotomy during OVB was associated with much lower OASIs rates in nulliparous women with a vacuum extraction; OR 0.23 (CI 95% 0.07-0.81) p = 0.037 in nulliparous women and the number necessary to treat was 18 among nulliparous women to prevent 1 OASIs. A further risk factor that emerged from the analysis is a prolonged expulsive period, whereas fundal pressure does not seem to have a statistically significant influence.
英文关键词	Operative vaginal birth obstetric anal sphincter injuries OASIs episiotomy perineal tear
类型	Article
语种	英语
开放获取类型	Green Published, hybrid
收录类别	SCI-E
WOS记录号	WOS:001043139700001
WOS关键词	RISK-FACTORS ; MEDIOLATERAL EPISIOTOMY ; POSTPARTUM HEMORRHAGE ; TEARS
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/2XILL650/397478
推荐引用方式 GB/T 7714	Ragusa, Antonio,Ficarola, Fernando,Svelato, Alessandro,et al. Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study[J],2023,36(2).
APA	Ragusa, Antonio.,Ficarola, Fernando.,Svelato, Alessandro.,De Luca, Caterina.,D'Avino, Sara.,...&Manella, Paolo.(2023).Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study.JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE,36(2).
MLA	Ragusa, Antonio,et al."Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study".JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE 36.2(2023).