Incidence of episiotomy in Slovenia: The story behind the numbers

Došler, Anita Jug; Mivšek, RM Ana Polona; Verdenik, Ivan; MSc, RM Teja Škodič Zakšek; Levec, Tina; MSc, RM Petra Petročnik

doi:10.1111/nhs.12352

Cited by 9 publications

(14 citation statements)

References 32 publications

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“…The current episiotomy rate in France is close to the rate reported in the UK in 2011/2012 (15.20%) 3 . Though far lower than rates in Portugal (72.9%), Spain (43%) in 2010 or Slovenia (31.3%) in 2013, the French rate is still far higher than in Denmark (4.9%), Sweden (6.6%) or the United States (9.4%) in 2011 3 , 38 . In our study, the episiotomy rates of 14.3% in 2017 and 17.6% in 2016 for all vaginal deliveries are lower than the most recently published estimation (20.1% in 2016) 39 .…”

Section: Discussionmentioning

confidence: 86%

Episiotomy practices in France: epidemiology and risk factors in non-operative vaginal deliveries

Clesse

Cottenet

Lighezzolo-Alnot

et al. 2020

Sci Rep

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Episiotomy use has decreased due to the lack of evidence on its protective effects from maternal obstetric anal sphincter injuries. Indications for episiotomy vary considerably and there are a great variety of factors associated with its use. The aim of this article is to describe the episiotomy rate in France between 2013 and 2017 and the factors associated with its use in non-operative vaginal deliveries. In this retrospective population-based cohort study, we included vaginal deliveries performed in French hospitals (N = 584) and for which parity was coded. The variable of interest was the rate of episiotomy, particularly for non-operative vaginal deliveries. Trends in the episiotomy rates were studied using the Cochran-Armitage test. Hierarchical logistic regression was used to identify variables associated with episiotomy according to maternal age and parity. Between 2013 and 2017, French episiotomy rates fell from 21.6 to 14.3% for all vaginal deliveries (p < 0.01), and from 15.5 to 9.3% (p < 0.01) for all non-operative vaginal deliveries. Among non-operative vaginal deliveries, epidural analgesia, non-reassuring fetal heart rate, meconium in the amniotic fluid, shoulder dystocia, and newborn weight (≥ 4,000 g) were risk factors for episiotomy, both for nulliparous and multiparous women. On the contrary, prematurity reduced the risk of its use. For nulliparous women, breech presentation was also a risk factor for episiotomy, and for multiparous women, scarred uterus and multiple pregnancies were risk factors. In France, despite a reduction in episiotomy use over the last few years, the factors associated with episiotomy have not changed and are similar to the literature. This suggests that the decrease in episiotomies in France is an overall tendency which is probably related to improved care strategies that have been relayed by hospital teams and perinatal networks.

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Section: Discussionmentioning

confidence: 86%

Episiotomy practices in France: epidemiology and risk factors in non-operative vaginal deliveries

Clesse

Cottenet

Lighezzolo-Alnot

et al. 2020

Sci Rep

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“…An episiotomy is one of the widely used obstetric interventions which is done by the birth attendant to minimize the risk of severe tears which occur due to enlarging of the birth canal during childbirth at a time when the fetus's head descends [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Magnitude of Episiotomy and Associated Factors among Mothers Who Give Birth in Arba Minch General Hospital, Southern Ethiopia: Observation-Based Cross-Sectional Study

Fikadu

Boti

Tadesse

et al. 2020

Journal of Pregnancy

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Background. Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration. However, episiotomy should be done with judicious indication to lower perineal laceration with fewer complications. Despite its adverse effects, the magnitude of episiotomy is increasing due to different factors. Therefore, this study is aimed at determining the recent magnitude of episiotomy and at identifying associated factors among women who gave delivery in Arba Minch General Hospital, Southern Ethiopia. Methods. An institution-based cross-sectional study was conducted from December 15, 2018, to January 30, 2019. A systematic random sampling technique was used to select study participants. A semistructured questionnaire was used to collect data. This was supplemented with a review of the labor and delivery records. Binary and multivariable logistic regression analyses were performed to identify factors associated with the magnitude of episiotomy. P value ≤ 0.05 was used to determine the level of statistically significant variables. Results. The magnitude of episiotomy was found to be 272 (68.0%) with 95%CI=64.0‐72.5. Women who attended secondary education [AOR=10.24, 95%CI=2.81‐37.34], women who attended college and above [AOR=4.61, 95%CI=1.27‐16.71], birth weight≥3000 g [AOR=4.84, 95%CI=2.66‐8.82], primipara [AOR=4.13, 95%CI=2.40‐7.12], being housewife occupants [AOR=3.43, 95%CI=1.20‐9.98], married women [AOR=2.86, 95%CI=1.40‐5.84], and body mass index<25 kg/m2 [AOR=2.85, 95%CI=1.50‐5.44] were independent variables found to have significant association with episiotomy. Conclusion. The magnitude of episiotomy was 68.0% which is higher than the recommended practice by WHO (10%). The study participants’ occupational status, marital status, educational status, parity, birth weight, and BMI were significantly associated with the magnitude of episiotomy in the study area. Therefore, to reduce the rate of episiotomy, it is better to have periodic training for birth attendants regarding the indication of episiotomy.

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“…Episiotomy is a surgical cut of the perineum performed in the second stage of labor in order to facilitate the birth of an infant by enlarging the vaginal opening . Episiotomy became a routine practice well before research results were available to support it.…”

Section: Introductionmentioning

confidence: 99%

A multicenter cross‐sectional study of episiotomy practice in Romania

Pasc

Navolan²,

Puşcaşiu

et al. 2018

Evaluation Clinical Practice

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Rationale, aims, and objectives The aim of this study was to focus attention on episiotomy practice in Romanian maternity units in order to identify factors associated with the very high rate of the procedure in Romania and to consider strategies to reduce it. Methods In this clustered cross‐sectional study, a total of 11 863 patients were recorded in eight Romanian maternity units to assess the prevalence of episiotomy. A random effects Poisson model was used to estimate the prevalence rate in univariate and multivariate models. Results Among the 11 863 patients included for analysis, 8475 (71.4%) had an episiotomy. The prevalence of episiotomy was 92.7% for the first vaginal birth, 73.2% for the second vaginal birth, and 35% for the third vaginal birth. The overall rate of suturing was higher than the episiotomy rate for all patients (total rate 79.2%). The likelihood of exiting the maternity ward with an intact perineum after the first vaginal birth was less than 5% at the first vaginal birth. Conclusions In conclusion, routine episiotomy is the norm in Romanian maternity units, with episiotomy rates among the highest in Europe. Episiotomy use is mainly driven by local professional norms, experiences, previous training, and practitioners' decisions rather than evidence, guidelines, or variations in patient needs at the time of vaginal birth.

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Incidence of episiotomy in Slovenia: The story behind the numbers

Cited by 9 publications

References 32 publications

Episiotomy practices in France: epidemiology and risk factors in non-operative vaginal deliveries

Episiotomy practices in France: epidemiology and risk factors in non-operative vaginal deliveries

Magnitude of Episiotomy and Associated Factors among Mothers Who Give Birth in Arba Minch General Hospital, Southern Ethiopia: Observation-Based Cross-Sectional Study

A multicenter cross‐sectional study of episiotomy practice in Romania

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