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Database - (CIANE)

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Currently 3111 records
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https://ciane.net/id=566

Created on : 08 Mar 2004
Modified on : 05 Nov 2018

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Bibliographical entry (without author) :

Changed pattern in the use of episiotomy in Sweden. Br J Obstet Gynaecol. 1999 Feb;106(2):95-101.

Author(s) :

Röckner G, Fianu-Jonasson A.

Year of publication :

1999

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…
https://doi.org/10.1111/j.1471-0528.1999.tb08207.x

Résumé (français)  :

OBJECTIF : Etudier les changements dans l’utilisation de l’épisiotomie depuis 1989, en contrôlant les variables telles que les déchirures sévères, l’anesthésie péridurale, la durée du deuxième stade du travail, les accouchements avec instrument, le poids à la naissance et la position maternelle à l’accouchement.

DESIGN : Etude rétrospective. Les données ont été obtenues à partir des registres de naissance et des questionnaires.

CONTEXTE : Hôpital universitaire de Huddinge et toutes les salles de travail (n = 62) en Suède.

POPULATION : 10 661 femmes ayant accouché par voie vaginale (4575 nullipare, 6086 multiparae) entre 1992 et 1994 et 3366 nullipares livrées dans tous les hôpitaux suédois au cours du mois de mars 1995.

PRINCIPALES MESURES : Taux d’épisiotomie, déchirures graves et livraisons instrumentales.

RESULTATS : Le taux d’épisiotomie était de 1% et celui des larmes graves de 0,6% chez les multipares accouchés par voie vaginale (y compris les accouchements instrumentaux) à l’hôpital universitaire de Huddinge entre 1992 et 1994. Le taux d’épisiotomie était de 6,6% et celui des déchirures graves 2,3% chez les nullipares. L’extraction par ventouse et l’anesthésie épidurale étaient plus souvent associées à l’épisiotomie. Les facteurs significativement associés aux déchirures graves étaient le poids à la naissance du bébé ≥ 4 000 g, l’extraction par ventouse et l’épisiotomie. En 1995, dans toutes les salles de travail suédoises, l’incidence moyenne d’épisiotomie chez les nullipares était de 24,5%, soit une diminution significative par rapport à 33,7% en 1989. Les variations entre hôpitaux étaient importantes (4% à 50%).

CONCLUSION : Le recours à l’épisiotomie était beaucoup moins fréquent à l’hôpital universitaire de Huddinge, avec un taux de déchirures sévères toujours faible. Cela corrobore les preuves de plus en plus nombreuses d’une utilisation individualisée et restrictive de l’épisiotomie lors de l’accouchement.

Abstract (English)  :

OBJECTIVE: To study changes in the use of episiotomy since 1989, controlling for variables such as severe tears, epidural anaesthesia, duration of the second stage of labour, instrumental deliveries, birthweight and maternal position at delivery.

DESIGN: Retrospective study. Data were obtained from original birth records and questionnaires.

SETTING: Huddinge University Hospital and all labour wards (n = 62) in Sweden.

POPULATION: 10,661 women who were delivered vaginally (4575 nulliparae, 6086 multiparae) between 1992 and 1994, and 3366 nulliparae delivered in all Swedish hospitals during the month of March 1995.

MAIN OUTCOME MEASURES: Episiotomy rates, severe tears and instrumental deliveries.

RESULTS: The rate of episiotomy was 1% and of severe tears 0.6% among multiparae delivered vaginally (including instrumental deliveries) at Huddinge University Hospital between 1992 and 1994. The rate of episiotomy was 6.6% and of severe tears 2.3% among nulliparae. Vacuum extraction and epidural anaesthesia were more commonly associated with episiotomy. Factors significantly associated with severe tears were infant birthweight > or = 4000 g, vacuum extraction and episiotomy. In all Swedish labour wards in 1995 the mean incidence of episiotomy in nulliparae was 24.5%, a significant decrease from 33.7% in 1989. Wide variations occurred between hospitals (4%-50%).

CONCLUSION: The use of episiotomy was much reduced at Huddinge University Hospital, with a consistently low rate of severe tears. This supports the growing evidence for individualised and restrictive use of episiotomy at childbirth.

Sumário (português)  :

OBJECTIVO: Para estudar as alterações na utilização de episiotomia desde 1989, controlar as variáveis ​​tais como lacerações graves, a anestesia epidural, a duração da segunda fase do trabalho de parto, com entregas instrumento, o peso à nascença e a posição materna no parto.

PROJETO: Estudo retrospectivo. Os dados foram obtidos a partir de registros de nascimento e questionários.

HISTÓRICO: Hospital da Universidade de Huddinge e todas as salas de trabalho (n = 62) na Suécia.

POPULAÇÃO: 10.661 mulheres que tiveram parto vaginal (4575 nulíparas, multíparas 6086) entre 1992 e 1994 e 3366 nulíparas entregues em todos os hospitais suecos durante Março de 1995.

MEDIDAS PRINCIPAIS: Taxa de episiotomia, rupturas graves e partos instrumentais.

RESULTADOS: A taxa de episiotomia foi de 1% e as lágrimas graves 0,6% em accouchés multíparas vaginalmente (incluindo partos instrumentais) no Huddinge Hospital Universitário entre 1992 e a taxa de 1994. episiotomia foi de 6,6% e lacerações graves 2,3% em nulíparas. A aspiração e a anestesia peridural associaram-se mais freqüentemente à episiotomia. O significativamente associado com factores lacerações graves foram nascimento do bebé peso ≥ 4,000 g, extracção por vácuo e episiotomia. Em 1995, todas as salas de estudo sueco, a incidência média de episiotomia em mulheres nulíparas foi de 24,5%, uma diminuição significativa de 33,7% em 1989. As variações entre os hospitais eram importantes (4 % a 50%).

CONCLUSÃO: O uso da episiotomia foi muito menos freqüente na Universidade Hospital Huddinge, com taxas ainda baixas lacerações graves. Isto corrobora a evidência de um número crescente de uso individualizado e restritivo da episiotomia durante o parto.

Resumen (español)  :

Full text (public) :

Comments :

Cette étude met en évidence les biais de l’étude de De Leeuw et collègues, 2001 (http://afar.info/id=755) comme nous l’avons montré sur un dossier du CIANE (https://ciane.net/wiki/pmwiki.php?n=Ciane.RPCepisiotomie)

Argument (français) :

L’utilisation de l’épisiotomie a fortement diminué à l’hôpital universitaire de Huddinge, avec un taux systématiquement bas de déchirures sévères. Cela corrobore les preuves de plus en plus nombreuses d’une utilisation individualisée et restrictive de l’épisiotomie lors de l’accouchement.

Argument (English):

The use of episiotomy was much reduced at Huddinge University Hospital, with a consistently low rate of severe tears. This supports the growing evidence for individualised and restrictive use of episiotomy at childbirth.

Argumento (português):

O uso da episiotomia diminuiu drasticamente no Hospital Universitário de Huddinge, com uma taxa consistentemente baixa de lágrimas severas. Isso corrobora a crescente evidência de um uso individualizado e restritivo da episiotomia durante o parto.

Argumento (español):

Keywords :

➡ evidence-based medicine/midwifery ; perineal/vaginal tears ; episiotomy ; epidural ; vacuum extraction (ventouse)

Author of this record :

Cécile Loup — 08 Mar 2004
➡ latest update : Bernard Bel — 05 Nov 2018

Related records
Group ‘Discussion of épisiotomy and obstetrical tears
Pinned by #755   J. W. de Leeuw, P. C. Struijk, M. E. Vierhout, H. C. S. Wallenburg (2001). Risk factors for third degree perineal ruptures during delivery. BJOG: An International Journal of Obstetrics and Gynaecology. Vol. 108 Issue 4 Page 383 April 2001 ➡ https://ciane.net/id=755
Pinned by #2257   D. Riethmuller (2008). Épisiotomie et extraction instrumentale : la mise à mort des RPC du CNGOF ? À propos de l’article Mediolateral episiotomy reduces the risk for anal sphincter injury during operative vaginal delivery. BJOG 2008; 115:104—8 ➡ tps://ciane.net/id=225757
Pinned by #2258   JW de Leeuw, C de Wit, JPJA Kuijken, HW Bruinse (2007). Mediolateral episiotomy reduces the risk for anal sphincter injury during operative vaginal delivery. BJOG: An International Journal of Obstetrics & Gynaecology Volume 115 Issue 1, Pages 104 - 108 ➡ https://ciane.net/id=2258
Pinned by #2260   X. Fritel, J. -P. Schaal, A. Fauconnier, V. Bertrand, C. Levet, A. Pigné (2008). Troubles périnéaux quatre ans après le premier accouchement : comparaison entre épisiotomie restrictive et systématique. Journal de Gynécologie Obstétrique et Biologie de la Reproduction. Gynécologie Obstétrique & Fertilité. Volume 36, numéro 10, pages 991-997. ➡ https://ciane.net/id=2260
Pinned by #2530   de Vogel, Joey; van der Leeuw-van Beek, Anneke; Gietelink, Dirk; Vujkovic, Marijana; de Leeuw, Jan Willem; van Bavel, Jeroen; Papatsonis, Dimitri (2012). The effect of a mediolateral episiotomy during operative vaginal delivery on the risk of developing obstetrical anal sphincter injuries - American Journal of Obstetrics and Gynecology - Vol. 206, 5 - ISBN: 0002-9378 - p.404.e1-404.e5 ➡ https://ciane.net/id=2530
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