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Modified on : 02 Aug 2014

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Bibliographical entry (without author) :

Pelvic floor disorders 4 years after first delivery: a comparative study of restrictive versus systematic episiotomy - BJOG: An International Journal of Obstetrics & Gynaecology - Vol. 115, 2 - ISBN: 1471-0528 - p.247-252

Author(s) :

Fritel, X; Schaal, Jp; Fauconnier, A; Bertrand, V; Levet, C; Pigné, A

Year of publication :

2008

URL(s) :

http://onlinelibrary.wiley.com/doi/10.1111/j.1471-…
https://doi.org/10.1111/j.1471-0528.2007.01540.x

Résumé (français)  :

Abstract (English)  :

Objective  To compare two policies for episiotomy: restrictive and systematic. Design  Quasi-randomised comparative study. Setting  Two French university hospitals with contrasting policies for episiotomy: one using episiotomy restrictively and the second routinely. Population  Seven hundred and seventy-four nulliparous women delivered during 1996 of a singleton in cephalic presentation at a term of 37–41 weeks. Methods  A questionnaire was mailed 4 years after delivery. Sample size was calculated to allow us to show a 10% difference in the prevalence of urinary incontinence with 80% power. Main outcome measures  Urinary incontinence, anal incontinence, perineal pain, and pain during intercourse. Results  We received 627 responses (81%), 320 from women delivered under the restrictive policy, 307 from women delivered under the routine policy. In the restrictive group, 186 (49%) deliveries included mediolateral episiotomies and in the routine group, 348 (88%). Four years after the first delivery, there was no difference in the prevalence of urinary incontinence (26 versus 32%), perineal pain (6 versus 8%), or pain during intercourse (18 versus 21%) between the two groups. Anal incontinence was less prevalent in the restrictive group (11 versus 16%). The difference was significant for flatus (8 versus 13%) but not for faecal incontinence (3% for both groups). Logistic regression confirmed that a policy of routine episiotomy was associated with a risk of anal incontinence nearly twice as high as the risk associated with a restrictive policy (OR = 1.84, 95% CI: 1.05–3.22). Conclusions  A policy of routine episiotomy does not protect against urinary or anal incontinence 4 years after first delivery.

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Keywords :

➡ episiotomy

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Import 02/08/2014 — 02 Aug 2014