干旱区生态环境知识资源中心(Arid): Episiotomy practice in France and prevention of high-grade perineal tears at the time of operative vaginal delivery: a prospective multicentre ancillary cohort study

Arid

DOI	10.1007/s00192-023-05640-z
	Episiotomy practice in France and prevention of high-grade perineal tears at the time of operative vaginal delivery: a prospective multicentre ancillary cohort study
	Evangelopoulos, Nikolaos; Duraes, Martha; Cayrac, Melanie; Galtier, Fannette; Fritel, Xavier; Gachon, Bertrand; De Tayrac, Renaud
通讯作者	Evangelopoulos, N
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2024
卷号	35 期号:2 页码:319-326
英文摘要	Introduction and hypothesis Evidence suggests that episiotomies reduce the risk for obstetric anal sphincter injuries (OASIs) in operative vaginal deliveries (OVDs). However, there is limited evidence on the importance of episiotomy technique in this context. The primary objective of this study was to assess if an episiotomy suture angle >45 degrees from the median line would be associated with a lower risk for OASIs at the time of OVD. Methods This was an ancillary study from the multicentre prospective cohort INSTRUMODA study. Of the 2,620 patients who had an OVD with a concomitant episiotomy between April 2021 and March 2022, a total of 219 fulfilled the inclusion criteria. Post-suturing photographs were used to assess episiotomy characteristics. Results Based on suture angles of <= 45 degrees and >45 degrees the study cohort was categorized into groups A (n = 155) and B (n = 64) respectively. The groups had comparable demographic and birth-related characteristics. The mean episiotomy length was significantly longer in group A than in group B (3.21 cm vs 2.84 cm; p = 0.009). Senior obstetricians performed more acute angled episiotomies than junior residents (p = 0.016). The total prevalence of OASIS was 2.3%, with no significant difference in rate of OASI between the two study groups. Birthweight was significantly higher in OASI births (p = 0.018) and spatula-assisted births were associated with higher risk for OASIs than ventouse or forceps (p = 0.0039). Conclusions This study did not demonstrate a significant reduction in risk for OASI at the time of OVD when the episiotomy suture angle was >45 degrees from the median line. However, these results should be interpreted with caution owing to the low prevalence of OASIs in our cohort.
英文关键词	Episiotomy angle Episiotomy length Mediolateral OASIs Operative vaginal delivery
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:001060187700001
WOS关键词	ANAL-SPHINCTER INJURIES ; MEDIOLATERAL EPISIOTOMY ; RISK-FACTORS ; INCISION ANGLE ; 3RD-DEGREE ; HEALTH ; TRENDS
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/2XILL650/404279
推荐引用方式 GB/T 7714	Evangelopoulos, Nikolaos,Duraes, Martha,Cayrac, Melanie,et al. Episiotomy practice in France and prevention of high-grade perineal tears at the time of operative vaginal delivery: a prospective multicentre ancillary cohort study[J],2024,35(2):319-326.
APA	Evangelopoulos, Nikolaos.,Duraes, Martha.,Cayrac, Melanie.,Galtier, Fannette.,Fritel, Xavier.,...&De Tayrac, Renaud.(2024).Episiotomy practice in France and prevention of high-grade perineal tears at the time of operative vaginal delivery: a prospective multicentre ancillary cohort study.INTERNATIONAL UROGYNECOLOGY JOURNAL,35(2),319-326.
MLA	Evangelopoulos, Nikolaos,et al."Episiotomy practice in France and prevention of high-grade perineal tears at the time of operative vaginal delivery: a prospective multicentre ancillary cohort study".INTERNATIONAL UROGYNECOLOGY JOURNAL 35.2(2024):319-326.