Effectiveness of episiotomy to prevent <scp>OASIS</scp> in nulliparous women at term

Perrin, Antoine; Korb, Diane; Morgan, Rosemary; Sibony, Olivier

doi:10.1002/ijgo.14706

Cited by 1 publication

(1 citation statement)

References 24 publications

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“…The potential for episiotomy to be protective of severe perineal trauma in nulliparous remains contentious with recent RCTs and reviews questioning any bene t with the possible exception of assisted birth. [37][38][39] However the rise in episiotomy in nulliparous women was greater than the percent increase in assisted vaginal births. Recent rises in episiotomy use in Australia have been attributed to increased implementation of perineal protection bundles however associated reductions in severe perineal trauma have not been demonstrated in unassisted vaginal births.…”

Section: Population Demographicsmentioning

confidence: 99%

Trends in induction of labour and associated co-morbidities and demographics in Queensland, Australia from 2001 – 2021: A population-based study

Lee,

Ballard,

Humphrey

2024

Preprint

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Background Amongst women who plan a vaginal birth at term, previous studies have reported that rates of induction of labour are increasing potentially impacting other labour and birth outcomes. Indications for induction of labour (IOL) have changed over time though the influences of parity and demographic factors such as age, ethnicity and regionality are not often considered. The aim of this study was to describe the changes in demographic, co-morbidity, IOL indication and clinical outcomes in women undertaking a planned cephalic vaginal birth at term over a 20 year period. Methods A retrospective population-based study was undertaken using routinely collected anonymised perinatal data from Queensland, Australia from January 2001 to December 2020. We included all singleton term (≥ 37 weeks) planned vaginal births. A total of 836,065 births met the study criteria. Data for pregnancy complications and IOL indications were grouped by ICD-10 codes. Categorical data was analysed and stratified by parity with percent changes over time calculated for all variables. Results Rates of IOL increased by 13% (34.1–47.1%) in nulliparous and 11.5% (29.3–40.8%) in multiparous women, most notable from 2015 onwards. During the study period the percentage of infants born between 37 and 38 weeks gestation increased by 13.9%. Amongst co-morbidities diabetes increased from 3.8–12.8% and anaemia from 2.3–8.1%. As an indication for IOL prolonged pregnancy decreased from 41.0–11.2%. In nulliparous women the percentage of intact perineum decreased from 21.3–6.7% while episiotomy increased from 20.2–38.8%. Conclusions We conclude that for women planning a vaginal birth not only has the rate of IOL increased substantially over the last two decades there also appears to be considerable interaction between demographic, co-morbidity, IOL indications and clinical outcomes that warrants further large population-based research.

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Section: Population Demographicsmentioning

confidence: 99%