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Created on : 12 May 2004
Modified on : 01 Dec 2007

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Bibliographical entry (without author) :

Differences in episiotomy technique between midwives and doctors. BJOG: An International Journal of Obstetrics & Gynaecology. Volume 110 Issue 12 Page 1041 - December 2003

Author(s) :

Douglas G. Tincelloa*, Abimbola Williamsb, Gillian E. Fowlerb, Elisabeth J. Adamsb, David H.
Richmondb, Zarko Alfirevicc

Year of publication :

2003

URL(s) :

http://www.blackwell-synergy.com/links/doi/10.1111…

Résumé (français)  :

Abstract (English)  :

Objectives
To examine the practice of making an episiotomy and to determine any differences in practice
between professional groups.

Design
A prospective survey.

Setting
A large tertiary referral obstetric hospital and the obstetric department of a district general hospital.

Population
All staff routinely involved in the care of women in labour.

Methods
A novel validated pictorial questionnaire was designed, validated and distributed to the study
population. Differences in outcome measures were compared by profession and by seniority.

Main outcome measures
Measurements taken from the questionnaire: the length of episiotomy drawn; the distance from the sagittal plane at which the episiotomy was begun; and the angle of the episiotomy from the sagittal plane.

Results
Fifty doctors and 78 midwives completed the forms. Median distance of the episiotomy from the
midline was 0 mm (2 to 11). Episiotomies drawn by doctors were significantly longer and more angled than
those drawn by midwives (P= 0.002 and P= 0.001). Sixteen percent of doctors and 1% of midwives drew
an episiotomy longer than 20 mm (difference 15%, 95% CI 6 to 24). Twenty-three percent of midwives and
2% of doctors drew an episiotomy angled 30° or less (difference 21%, 95% CI 9 to 34).

Conclusions
This study has demonstrated differences in the reporting of episiotomy practice by doctors and
midwives. Theoretically, the differences demonstrated could predispose to a greater risk of anal sphincter
injuries. These data need to be confirmed by observational studies of actual practice and by studies to
investigate the mechanics of sphincter injury during childbirth.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Argument (English):

Argumento (português):

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Keywords :

➡ episiotomy

Author of this record :

Bernard Bel — 12 May 2004