Impact of a selective use of episiotomy combined with Couder’s maneuver for the perineal protection

Forey, Pierre-Louis; Lallemant, Marine; Bourtembourg-Matras, Aude; Eckman-Lacroix, Astrid; Ramanah, R.; Riethmuller, Didier; Mottet, Nicolas

doi:10.1007/s00404-020-05572-9

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…Prophylactic use of episiotomy in critical conditions such as shoulder dystocia, instrumental deliveries, occiput-posterior position, fetal macrosomia and non-reassuring fetal heart patterns don't prevent 3rd or 4th degree perineal tear ( 11 ). Nonetheless, a comparative, retrospective, mono-centric study in a university maternity unit in Besançon, France, found that selective episiotomy could reduce the incidence of perineal tears, particularly second-degree perineal tears, without increasing the rate of OASIS ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundEpisiotomy, a surgical procedure that enlarges the vaginal opening during childbirth, was common practice until the early 2000s. Other sources, including the World Health Organization (WHO), advocate for the selective use of episiotomy. Episiotomy rates, on the other hand, have remained high in developing countries, while declining in developed countries. As a result, the current study sought to determine the overall prevalence of episiotomy in Africa as well as the risk factors associated with its practice.MethodsArticles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 14 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. A random-effects meta-analysis model was used to determine the pooled prevalence of episiotomy. A heterogeneity test was conducted using I-Squared (I2) statistics. Egger's test and funnel plots were conducted to detect publication bias. Subgroup analysis was also conducted. Association was expressed through a pooled odds ratio (OR) with a 95% Confidence Interval (CI).ResultA total of 21 studies with 40,831 participants were included in the systematic review and meta-analysis. The pooled prevalence of episiotomy practice was 41.7% [95% CI (36.0–47.4), I2 = 99.3%, P < 0.001). Primiparity [OR: 6.796 (95% CI (4.862–9.498)), P < 0.001, I2: 95.1%], medical doctors- assisted delivery [OR: 3.675 (95% CI (2.034–6.640)), P < 0.001, I2: 72.6%], prolonged second stage of labor [OR: 5.539 (95% CI (4.252–7.199)), P < 0.001, I2: 0.0%], using oxytocin [OR: 4.207 (95% CI (3.100–5.709)), P < 0.001, I2: 0.0%], instrument -assisted vaginal delivery [OR: 5.578 (95% CI (4.285–7.260)), P < 0.001, I2: 65.1%], and macrosomia [OR: 5.32 (95% CI (2.738–10.339)), P < 0.001, I2: 95.1%] were factors associated with episiotomy practice.ConclusionIn this review, the prevalence of episiotomy among African parturients was high. A selective episiotomy practice should be implemented to reduce the high episiotomy rates.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021293382, identifier: CRD42021293382.

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Section: Introductionmentioning

confidence: 99%

Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis

et al. 2022

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“…Our high randomization rate can be explained by our using several training sessions and our regular involvement of our team members in research protocols evaluating the prevention of perineal tears with restrictive use of episiotomy and careful delivery of shoulders with active delivery of the anterior arm using Couder's maneuver. 9,10 Our study showed a higher REEDA score and edema in the systematic suture group at day 10 and a lower REEDA score in the conservative management group at 2 months postpartum. These results align with our hypothesis that less reactional edema occurs in the absence of sutures.…”

Section: Discussionmentioning

confidence: 49%

“…The main reason given for this low randomization rate was nonadherence by the midwives' team to the study protocol. Our high randomization rate can be explained by our using several training sessions and our regular involvement of our team members in research protocols evaluating the prevention of perineal tears with restrictive use of episiotomy and careful delivery of shoulders with active delivery of the anterior arm using Couder's maneuver 9,10 .…”

Section: Discussionmentioning

confidence: 99%

Conservative management versus systematic suture of isolated vaginal or first‐degree perineal tears after delivery: A preliminary randomized efficacy trial

Lallemant

D'Antona

Vidal³

et al. 2022

Birth

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HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…Menurut Jiang et al, (2017) beberapa praktisi kebidanan meyakini bahwa tindakan episiotomy dapat mencegah rupture perineum yang parah, namun sebaliknya tindakan episiotomy dapat memperparah rupture perineum dan hanya boleh dilakukan atas indikasi gawat janin. Menurut Forey et al, (2020) episiotomy dapat memperparah rupture perineum, menyebabkan nyeri perineum sampai 3 bulan postpartum, menyebabkan inkontinensia urin, dan mempengaruhi seksualitas Yolanda Montessori, Sri Handayani, Anjarwati Yolanda Montessori, et.al Dampak episiotomy bagi ibu postpartum juga dikuatkan oleh penelitian East et al, (2020) yang mengungkapkan bahwa tindakan episiotomy dapat meningkatkan rasa nyeri dalam beberapa jam, hari, bahkan beberapa bulan postpartum sehingga mengurangi kemampuan ibu postpartum untuk berjalan dan duduk dengan nyaman. Hal ini dapat mempengaruhi kemampuan untuk merawat bayi termasuk menyusui.…”

Section: A Dampak Fisikunclassified

Dampak rupture perineum pada ibu postpartum: studi kualitatif

Montessori¹,

Handayani²,

Anjarwati³

2021

JKK

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Penelitian ini bertujuan untuk mengkaji dampak rupture perineum pada ibu postpartum. Pendekatan fenomenologi dengan metode kualitatif digunakan dalam penelitian ini. Penelitian dilakukan di sebuah Rumah Sakit swasta di Kota Yogyakarta pada bulan Desember 2019 – Februari 2020. Sembilan ibu postpartum diwawancarai secara semi terstruktur menggunakan strategi purposive sampling. Rupture perineum dapat berdampak pada berbagai aspek. Dampak fisik yang dialami dapat berdampak pada kondisi psikologis, seksual, sosial, dan spiritual. Diharapkan intervensi yang tidak perlu selama proses persalinan dapat diminimalkan, sehingga diperlukan upaya pemberdayaan perempuan melalui upaya promotif dan preventif secara komprehensif, konsisten dan berkesinambungan.

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Impact of a selective use of episiotomy combined with Couder’s maneuver for the perineal protection

Cited by 7 publications

References 16 publications

Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis

Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis

Conservative management versus systematic suture of isolated vaginal or first‐degree perineal tears after delivery: A preliminary randomized efficacy trial

Dampak rupture perineum pada ibu postpartum: studi kualitatif

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