Document Detail


The practice of episiotomy in public hospitals in Hong Kong.
MedLine Citation:
PMID:  16603774     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the use of episiotomy during vaginal delivery in Hong Kong public hospitals. DESIGN: Prospective observational survey. SETTING: Public hospitals, Hong Kong. PARTICIPANTS: Women who underwent normal vaginal delivery of a singleton foetus with cephalic presentation. MAIN OUTCOME MEASURES: Number of women having an episiotomy, severe-degree (third- or fourth-degree) tear, other types of tear, blood loss at delivery, postpartum haemorrhage, need for blood transfusion, puerperal pyrexia, wound infection, gaping wound that required suture removal, and drainage or resuturing of a perineal wound. RESULTS: Between 1 January and 31 March 2003, there were 6222 singleton spontaneous normal vaginal deliveries in the public hospitals of Hong Kong. Of the 6167 women in whom the status of the perineum was known, episiotomy was performed in 5274 (85.5%). Primiparous women were more likely to undergo episiotomy at delivery than multiparous women (97.9% vs 71.4%). Women with episiotomy had significantly less perineal tearing of any kind than those without. The occurrence of any type of perineal tear and severe-degree (third- or fourth-degree) tear was significantly lower in primiparous women who had an episiotomy than those without (P<0.05). Women with episiotomy had increased mean blood loss at delivery but other complications were not significantly increased. CONCLUSIONS: In Hong Kong, episiotomy is routinely performed during normal vaginal delivery. It is associated with a significantly lower overall rate of perineal tearing. This study was observational, nonetheless the occurrence of other complications was likely to increase when episiotomy was performed. Firm evidence from several randomised controlled studies shows that routine episiotomy is unjustified and possibly harmful. Routine episiotomy should not be promoted in Hong Kong without further randomised controlled study.
Authors:
K W Lam; H S Wong; T C Pun
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine     Volume:  12     ISSN:  1024-2708     ISO Abbreviation:  Hong Kong Med J     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-10     Completed Date:  2006-09-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512509     Medline TA:  Hong Kong Med J     Country:  China    
Other Details:
Languages:  eng     Pagination:  94-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. kawai7@hkucc.hku.hk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Case-Control Studies
Episiotomy / adverse effects*,  utilization
Female
Hong Kong / epidemiology
Humans
Middle Aged
Obstetric Labor Complications / epidemiology,  etiology
Parity
Perineum / injuries
Physician's Practice Patterns
Pregnancy

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


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