Document Detail


Episiotomy and perineal tears in low-risk UK primigravidae.
MedLine Citation:
PMID:  9923949     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of the study was to determine the rates and to describe the risk factors for episiotomy and perineal tears in low-risk primigravidae. METHOD: A cross-sectional survey of 101 randomly selected NHS hospitals in the UK was carried out between February 1993 and January 1994. Subjects were 40 consecutive low-risk primigravidae in each hospital. The main outcome measures were number and reasons for episiotomy, and number and degree of perineal tears. RESULTS: A large proportion of women (83 per cent) experienced some form of perineal trauma. Forty per cent of the women had an episiotomy only, 6 per cent an episiotomy and perineal tear, and 37 per cent perineal or other tears without episiotomy. The main reasons for performing an episiotomy were foetal distress (27 per cent), impending tear (25 per cent) and delay of the second stage of labour (21 per cent). Fifty-nine per cent of women with a delayed second stage had a spontaneous vaginal delivery and 41 per cent required instrumental assistance. The likelihood of having an episiotomy increased with the duration of the second stage of labour, irrespective of type of delivery. Episiotomy rates varied appreciably throughout regions and hospitals in the United Kingdom, ranging from 26 to 67 per cent. There was also a large regional variation in the rates of perineal trauma; generally, high rates of one outcome were associated with low rates of the other. Compared with white women, women from the Indian sub-continent were almost twice as likely and those from the Orient almost five times as likely to have an episiotomy. CONCLUSIONS: The magnitude of the geographical variation suggests a lack of uniformity in indications for performing episiotomies and that guidelines for performing episiotomies may need to be reviewed. The rates of episiotomy in women from the Indian sub-continent and Orient were very high compared with those for white women, and this requires clarification and explanation, as they are contrary to rates experienced in these ethnic groups in other countries.
Authors:
F L Williams; C du V Florey; G J Mires; S A Ogston
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of public health medicine     Volume:  20     ISSN:  0957-4832     ISO Abbreviation:  J Public Health Med     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-04-19     Completed Date:  1999-04-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9011205     Medline TA:  J Public Health Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  422-7     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Public Health, University of Dundee, Ninewells Hospital and Medical School.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Sectional Studies
Episiotomy / utilization*
Female
Great Britain
Humans
Incidence
Infant, Newborn
Labor Stage, Second
Obstetric Labor Complications / epidemiology*
Parity
Perineum / injuries*
Pregnancy
Risk Factors
State Medicine / statistics & numerical data
Comments/Corrections
Comment In:
J Public Health Med. 1999 Sep;21(3):358-9   [PMID:  10528968 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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