Mersin University Faculty of Medicine, Department of Obstetrics and Gynecology, Mersin, Turkey.
Mersin University Faculty of Medicine, Department of Obstetrics and Gynecology, Mersin, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2014 Feb;173:34-7. doi: 10.1016/j.ejogrb.2013.11.010. Epub 2013 Nov 23.
This study aimed to assess the association between episiotomy and measures of pelvic organ prolapse quantification system (POP-Q) in a cohort of women with vaginal parturition.
A prospective study was conducted with 549 eligible patients with vaginal delivery history. Women who were pregnant, gave birth within the preceding 6 months period, had a known history of pre-pregnant prolapse, had a history of hysterectomy or any operation performed for pelvic organ prolapsus and stress urinary incontinence, refused to participate and to whom POP-Q examination could not be performed (due to anatomic or orthopedic problems) were excluded. Patients were categorized as women with episiotomy and without episiotomy. The degree of genital prolapse was assessed by using POP-Q system. The effect of episiotomy on overall POP-Q stage and individual POP-Q points was calculated with logistic regression.
439 patients had a history of episiotomy whereas 110 patients had no episiotomy. 38.2% of women without an episiotomy, and 32.0% of women with episiotomy had genital prolapse determined by POP-Q system. There was no statistically significant association between episiotomy and POP-Q stage (AOR, -0.24; 95% CI, -0.65-0.18, P=0.26). Episiotomy was found among the independent predictors for certain POP-Q points such as Bp, perineal body (pb) and total vaginal length (tvl). Episiotomy was negatively correlated with prolapse of Bp and with pb and tvl.
Episiotomy had an effect on certain POP-Q indices, but had no influence on overall POP-Q stage.
本研究旨在评估会阴切开术与阴道分娩女性盆腔器官脱垂定量系统（POP-Q）测量指标之间的关联。
这是一项前瞻性队列研究，纳入了 549 名符合条件的阴道分娩史女性。排除标准为：妊娠、分娩后 6 个月内、孕前有脱垂病史、有子宫切除术或任何盆腔器官脱垂和压力性尿失禁手术史、拒绝参与和无法进行 POP-Q 检查（由于解剖或骨科问题）的患者。将患者分为会阴切开术组和无会阴切开术组。采用 POP-Q 系统评估外阴脱垂程度。采用逻辑回归计算会阴切开术对整体 POP-Q 分期和个体 POP-Q 点的影响。
439 例患者有会阴切开术史，110 例患者无会阴切开术史。38.2%无会阴切开术的女性和 32.0%有会阴切开术的女性通过 POP-Q 系统确定存在外阴脱垂。会阴切开术与 POP-Q 分期之间无统计学显著关联（优势比，-0.24；95%置信区间，-0.65-0.18，P=0.26）。会阴切开术是某些 POP-Q 点（如 Bp、会阴体（pb）和阴道总长度（tvl））的独立预测因素。会阴切开术与 Bp 脱垂、pb 和 tvl 呈负相关。
会阴切开术对某些 POP-Q 指数有影响，但对整体 POP-Q 分期无影响。
