妊娠と小児の健康に関するジャーナル

抽象的な

Impact of Episiotomy at Vaginal Delivery

Elliot M Levine, Kimberly Bannon, Carlos M Fernandez and Stephen Locher

A comparison was made of episiotomy rates and the rates of advanced perineal lacerations (APL) between different modern times, in order to view the likely consequences of performing episiotomy at vaginal delivery, and to consider applying this to obstetric quality standards.

Study design: A Structured Query Language (SQL) perinatal database, used in a community hospital, was used to investigate the prevalence of episiotomy performed at vaginal delivery and the incidence of APL, for a comparison between different time periods. The type of obstetric provider, the type of episiotomy if performed, any associated operative procedures, neonatal birth weight and Apgar scores, estimated blood loss, and other obstetric variables were reviewed.

Results: The average episiotomy rate steadily declined from 1996-1998, 2003-2005 and 2012-2014. The rate of advanced perineal lacerations coincidentally rose during these time period comparisons.

Conclusion: Obstetric providers may need to consider the likely outcome at vaginal delivery when considering performing an episiotomy. Quality standards may need to more properly focus on the incidence of APL, rather than the episiotomy rate, given the clinical data that the authors examined.