A multicenter cross-sectional study of episiotomy practice in Romania.
Romania
episiotomy
episiotomy rate
vaginal birth
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
14
10
2018
accepted:
15
10
2018
pubmed:
15
11
2018
medline:
31
7
2019
entrez:
15
11
2018
Statut:
ppublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 30426613
doi: 10.1111/jep.13062
pmc: PMC6587480
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Pagination
306-311Informations de copyright
© 2018 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.
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