de Tayrac R, Panel L, Masson G, Mares P
Service de Gynécologie-Obstétrique, Hôpital Carémeau, place du Professeur-Robert-Debré, 30900 Nîmes Cedex 9.
J Gynecol Obstet Biol Reprod (Paris). 2006 Feb;35(1 Suppl):1S24-1S31.
The objective of this review was to assess the efficacy of episiotomy to prevent severe perineal tears, urinary incontinence, faecal incontinence and genital prolapse.
A systematic review on Medline database was performed between 1980 and 2005. One hundred seventy seven articles were selected. Trial quality was assessed on the following parameters: design (prospective, randomized, meta-analysis), sample size (>50) and relevant results. Finally, 43 articles were analysed.
The routine use of episiotomy did not prevent severe perineal tears. It decreased the risk of moderate anterior perineal lacerations. The risk of severe perineal tears during episiotomy increased in the following circumstances: primiparity, Asian women, perineal length<or=3cm, forceps or vacuum-assisted deliveries and macrosomia. Relevant studies were consistent in demonstrating no benefit for routine episiotomy to prevent urinary or faecal incontinence or pelvic floor relaxation, even if there is a lack of data concerning long-term effects on pelvic floor support.
The routine use of episiotomy to prevent severe perineal tears, urinary incontinence, faecal incontinence and genital prolapse should be abandoned.
本综述的目的是评估会阴切开术在预防严重会阴撕裂、尿失禁、粪失禁和生殖器脱垂方面的疗效。
对1980年至2005年间的Medline数据库进行系统综述。共筛选出177篇文章。根据以下参数评估试验质量：设计（前瞻性、随机、荟萃分析）、样本量（>50）和相关结果。最终分析了43篇文章。
常规会阴切开术不能预防严重会阴撕裂。它降低了中度会阴前部撕裂的风险。在以下情况下，会阴切开术期间严重会阴撕裂的风险增加：初产、亚洲女性、会阴长度≤3cm、产钳或真空辅助分娩以及巨大儿。相关研究一致表明，常规会阴切开术对预防尿失禁或粪失禁或盆底松弛没有益处，尽管缺乏关于对盆底支持长期影响的数据。
应摒弃常规会阴切开术预防严重会阴撕裂、尿失禁、粪失禁和生殖器脱垂的做法。
Zotero 插件