Pelvic floor disorders 4 years after first delivery: a comparative study of restrictive versus systematic episiotomy.
BJOG
; 115(2): 247-52, 2008 Jan.
Article
em En
| MEDLINE
| ID: mdl-17970794
ABSTRACT
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 OUTCOMEMEASURES:
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Episiotomia
/
Doenças Urogenitais Femininas
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Complicações do Trabalho de Parto
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article