Frequency of episiotomy and complications in the Obstetrics Service of Hospital Universitario San José, Popayán (Colombia), 2016. Exploration of maternal and perinatal factors associated with its performance
DOI:
https://doi.org/10.18597/rcog.3030Keywords:
Episiotomy, parity, perineum, delivery, obstetricAbstract
Objective: To determine the frequency with which episiotomy is performed, explore factors associated with its performance, and describe maternal and perinatal outcomes in the obstetric service of San José University Hospital in the city of Popayán (Colombia) during the first semester of 2016.
Materials and methods: Descriptive, cross-sectional study with secondary analysis which included pregnant women with more than 37 weeks of gestation delivered during the first semester of 2016 in a high complexity public referral centre in the Department of Cauca Colombia, which serves patients covered by both the contributive as well as the subsidised health insurance regimes. A simple random sampling was used with a sample size of 197 deliveries and a margin of error of 5%. Maternal and childbirth variables, as well as maternal and neonatal outcomes were assessed. The frequency of episiotomy was estimated and the factors associated with its performance were explored by means of bivariate and multivariate analysis.
Results: The frequency with which episiotomy was performed was 30.45% (n = 60; 95% CI: 24.1-37.3), and the most frequent complication was perineal tear at 29% (95% CI: 22.9-35.5). In terms of risk factors, nulliparity was the only factor associated with the need to perform episiotomy (OR = 16.11; 95% CI: 6.46-42.81).
Conclusion: Episiotomy is performed more frequently in this institution than recommended by the World Health Organisation (WHO). Strategies should be considered for reducing this frequency to the expected levels.Author Biographies
Andrés Martín Mellizo-Gaviria, Universidad del Cauca
Lina María López-Veloza
Richard Montoya-Mora
Roberth Alirio Ortiz-Martínez
Claudia Consuelo Gil-Walteros
References
Ballesteros Meseguer C, Carrillo García C, Meseguer de Pedro M, Canteras Jordana M, Martínez Roche M. La episiotomía y su relación con distintas variables clínicas que influyen en su realización. Rev Lat Am Enfermagem. 2016;24:1-6.
Silva CN, Coutada RS, Rocha A. Episiotomy: Early maternal and neonatal outcomes of selective versus routine use. Acta Obstet Ginecol Port. 2014;8:126-34.
Molina Reyes C, Huete Morales M, Sánchez Pérez JC, Ortiz Albarín M, Jiménez Barragán I, Aguilera Ruiz MA. Implantación de una política de episiotomía selectiva en el Hospital de Baza. Resultados materno-fetales. Prog Obstet Ginecol. 2011;54:101-108. https://doi.org/10.1016/j.pog.2011.01.008.
Rubio JA. Política selectiva de episiotomía y riesgo de desgarro perineal en un hospital universitario. Rev Colomb Obstet Ginecol. 2005;56:116-26.
Muhleman M, Aly I, Walters A, Topale N, Tubbs R. et al. To cut or not to cut, that is the question: A review of the anatomy, the technique, risks, and benefits of an episiotomy. Clin Anat. 2017;30:362-372. https://doi.org/10.1002/ca.22836.
Steiner N, Weintraub AY, Wiznitzer A, Sergienko R, Sheiner E. Episiotomy: The final cut? Arch Gynecol Obstet. 2012;286:1369-73. https://doi.org/10.1007/s00404-012-2460-x.
Dim C, Chigbu C, Obiora-Izuka C, Izuka E. Prevalence and predictors of episiotomy among women at first birth in Enugu, south-east Nigeria. Ann Med Health Sci Res. 2014;4:928-32. https://doi.org/10.4103/2141-9248.144916.
Oliveira D, Parente M, Calvo B, Mascarenhas T, Jorge R. A biomechanical analysis on the impact of episiotomy during childbirth. Biomech Model Mechanobiol. 2016;15:1523-34. https://doi.org/10.1007/s10237-016-0781-6.
Chehab M, Courjon M, Eckman-Lacroix A, Ramanah R, Maillet R, Riethmuller D. Influence d’une forte diminution du recours à l’épisiotomie sur le taux global de périnée intact et peu lésionnel dans une population d’une maternité de niveau III. La Revue Sage-Femme. 2014;13:278-84. https://doi.org/10.1016/j.sagf.2014.09.004.
Fodstad K, Staff AC, Laine K. Effect of different episiotomy techniques on perineal pain and sexual activity 3 months after delivery. Int Urogynecol J. 2014;25:1629-37. https://doi.org/10.1007/s00192-014-2401-2.
Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017; Issue 2: CD000081. https://doi.org/10.1002/14651858.CD000081.pub3.
American College of Obstetricians-Gynecologists. ACOG Practice Bulletin. Practice Bulletin No. 165: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Obstet Gynecol. 2016;128:e1-e15. https://doi.org/10.1097/AOG.0000000000001523
Grupo de Trabajo Técnico. Organización Mundial de la Salud. Cuidados en el parto normal: una guía práctica. Rev Hosp Mat Inf Ramón Sardá. 1999;18:78-80.
Ministerio de Salud y Protección Social (Colombia). Norma Técnica de Atención del Parto. 2007 [Visitado 2017 May 20]. Disponible en: http://207.58.191.15:8180/xmlui/bitstream/handle/123456789/42/Legal_34.pdf?sequence=1.
Carvalho CC, Souza ASR, Moraes Filho OB. Prevalence and factors associated with practice of episiotomy at a maternity school in Recife, Pernambuco, Brazil. Rev Assoc Med Bras. 2010;56:333-9. https://doi.org/10.1590/S0104-42302010000300020
Maribel EM. Frequency of use of episiotomy in the service of obstetrics of the infantile maternal hospital. Rev Med La Paz. 2009;15:27-31.
Trinh AT, Khambalia A, Ampt A, Morris JM, Roberts CL. Episiotomy rate in Vietnamese-born women in Australia: support for a change in obstetric practice in Viet Nam. Bull World Health Organ. 2013;91,350-356. https://doi.org/10.2471/BLT.12.114314.
Pérez Valero S. Episiotomía en partos vaginales eutócicos en el Hospital Universitario “La Ribera”. Nure Inv. 2013;10:1-6.
Arango F, Gómez JG, Zuleta JJ. Uso de prácticas clínicas durante el embarazo, parto, puerperio y recién nacido, en hospitales públicos de Manizales- Colombia, 2005. Rev Colomb Obstet Ginecol. 2005;56:271-80.
Braga GC, Clementino STP, Luz PFND, Scavuzzi A, Noronha Neto C, Amorim MMR. Risk factors for episiotomy: A case-control study. Rev Assoc Med Bras. 2014;60:465-72. https://doi.org/10.1590/1806-9282.60.05.015.
Oliveira LS, Brito LGO, Quintana SM, Duarte G, Marcolin AC. Perineal trauma after vaginal delivery in healthy pregnant women. São Paulo Med J. 2014;132:231-8. https://doi.org/10.1590/1516-3180.2014.1324710.
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