Frequency of perineal lacerations and episiotomy in a university hospital in the mountain region of Rio de Janeiro
DOI:
https://doi.org/10.33448/rsd-v9i8.5613Keywords:
Perineum; Episiotomy; Women's health.Abstract
Perineal laceration is the most common complication in childbirth, occurring in 85% of vaginal deliveries and, to avoid it, episiotomy has been a routine procedure for a long time. However, episiotomy has been discouraged due to lack of proof of its benefit and its association with several complications. The aim of this study was to analyze the frequency of perineal lacerations and the performance of episiotomy in a university hospital in the mountain region in Rio de Janeiro, Brazil. Medical records of pregnant women whose vaginal delivery was performed between December 2018 and March 2019 were included in the study. Data on the presence of perineal lesions, including their degree, location, need for raffia, episiotomy and weight of the newborn were collected. The hospital's statistical sector provided data on episiotomy in the past 10 years and a trend curve was drawn. Pearson's chi-square test was applied. 137 medical records of pregnant women aged 19-38 years were eligible. A frequency of 56.9% perineal lacerations was observed, with 2.5% of serius injuries, need for raffia in 78.2% of cases and 22.6% of episiotomy procedures, mainly due to the narrow perineum and not complacent. The weight of the newborns varied between 875g to 3890g and most were classified as normal weight (n = 119, 87.5%). High frequency of perineal lacerations, mainly of mild severity, was found, as well as high frequency of episiotomy. However, data show a reduction of this procedure in the last ten years.
References
Aguiar, S. V., Gonçalves, E. R., & Bezerra, L. R. P. S. (2019). Analysis of the incidence and prevalence of perineal laceration of obstetric causes in a tertiary maternity in Fortaleza-CE. Rev Med UFC, 59(1),39-43.
Althabe, F., Belizán, J. M., & Bergel, E. (2002). Episiotomy rates in primiparous women in Latin America: hospital based descriptive study. BMJ, 324(7343),945-6.
Amorim, M. M., Coutinho, I. C., Melo, I., & Katz, L. (2017). Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial. Reprod Health, 14(1),55.
Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Área Técnica de Saúde da Mulher. (2001). Parto, aborto e puerpério: assistência humanizada à mulher. Brasília: Ministério da Saúde.
Carroli, G., & Mignini, L. (2009). Episiotomy for vaginal birth (review). Cochrane Database of Systematic Reviews, 1(CD000081).
Chia, C. C., & Huang, S. C. (2012). Third- and fourth-degree perineal laceration in vaginal delivery. Taiwan J Obstet Gynecol, 51(1),148-52.
Corrêa Junior, M. D., & Passini Júnior, R. P. (2016). Selective episiotomy: indications, techinique, and association with severe perineal lacerations. Rev Bras Ginecol Obstet, 38(6),301-7.
Ferreira, E. R. X., Cerqueira, E. A. C, Nunes, I. M., Araújo, E. M., Carvalho, E. S. S., & Santos, L. M. (2018). Associação entre região do trauma perineal, problemas locais, atividades habituais e necessidades fisiológicas dificultadas. Rev Baiana Enferm, 32,1-12.
Garcia-Lausin, L., Perez-Botella, M., Duran, X., Rodríguez-Pradera, S., Gutierrez-Martí, M. J. & Escuriet, R. (2019). Relation between epidural analgesia and severe perineal laceration in childbearing women in Catalonia. Midwifery, 70, 76-83.
Handa, V. L., Blomquist, J. L., McDermott, K. C., Friedman, S., & Muñoz, A. (2012). Pelvic floor disorders after vaginal birth: effect of episiotomy, perineal laceration, and operative birth. Obstet Gynecol, 119(2 Pt 1), 233-9.
Jallad, K., Steele, S. E., & Barber, M. D. (2016). Breakdown of perineal laceration repair after vaginal delivery: a case-control study. Female Pelvic Med Reconstr Surg, 22(4),276-9.
Monteiro, M. V. C., Pereira, G. M. V., Aguiar, R.A. P, Azevedo, R. L., Correia-Junior, M. D., & Reis, Z. S. N. (2016). Risk factors for severe obstetric perineal lacerations. Int Urogynecol J, 27(1),61-7.
Moura, L. B. A, Prieto, L. N. T., & Gerk, M. A. S. (2017). A episiotomia de rotina é uma prática baseada em evidência? CuidArte Enferm, 11(2),269-78.
Naidoo, T. D., & Moodley, J. (2015). Obstetric perineal injury: risk factors and prevalence in a resource-constrained setting. Trop Doct, 45(4),252-4.
Sagi-Dain, L., Bahous, R., Caspin, O., Kreinin-Bleicher, I., Gonen, R., & Sagi, S. (2018). No episiotomy versus selective lateral/mediolateral episiotomy (EPITRIAL): an interim analysis. Int Urogynecol J, 29(3), 415-423.
Schmidt, L. M., Kindberg, S. F., Glavind-Kristensen, M., Bek, K. M., & Nohr E. A. (2018). Early secondary repair of labial tears, 1st and 2nd degree perineal lacerations and mediolateral episiotomies in a midwifery-led clinic. A retrospective evaluation of cases based on photo documentation. Sex Reprod Healthc, 17,75-80.
Steiner, N., Weintraub, A. Y., Wiznitzer, A., Sergienko, R. & Sheiner, E. (2012). Episiotomy: the final cut?. Arch Gynecol Obstet, 286(6),1369-73.
Yamasato, K., Kimata, C., Huegel, B., Durbin, M., Ashton, M. & Burlingame, J. M. (2016). Restricted episiotomy use and maternal and neonatal injuries: a retrospective cohort study. Arch Gynecol Obstet, 294(6),1189-94.
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Copyright (c) 2020 Georgia Grecca, Joao Marcelo Cecílio Ribeiro, Jhosanda Briceño Vitoi, Iago Danusio Castro de Sousa, Marcus Jose do Amaral Vasconcellos, Gustavo Falcão Gama
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