Sagi-Dain Lena, Sagi Shlomi
Department of Obstetrics and Gynecology, Carmel Medical Center, 7 Michal St., Haifa, Israel,
Int Urogynecol J. 2015 Aug;26(8):1213-9. doi: 10.1007/s00192-015-2680-2. Epub 2015 Apr 2.
Our objective was to assess episiotomy technique used in Israeli hospitals, to determine factors influencing incision parameters, and to review relevant up-to-date professional literature.
Using anonymous questionnaires, a survey was conducted among obstetricians and midwives in the four public hospitals in northern Israel over a 1-year period commencing in October 2013. In addition to demographic and professional data, the accoucheurs were asked to describe the technique they usually use to perform an episiotomy (length, angle, and distance of initiation point from midperineum).
Overall, 84 obstetricians and 32 midwives participated in the survey. Only 37.6% reported performing a mediolateral episiotomy, while the rest described the lateral type, placing the initiation point at an average distance of 2.45 ± 0.88 cm from the fourchette. Compared with midwives, obstetricians reported performing a significantly longer episiotomy (3.53 ± 1.01 vs. 2.73 ± 0.81 cm, p = 0.0002).
According to our study and relevant literature review, the technique of episiotomy varies significantly between health professionals and is not uniformly congruent with international practice guidelines. In part, this is derived from unclear literature evidence and lack of consensus definition for proper technique of this procedure by the national guidelines. Thus, further higher-quality research, uniform protocols, and educational programs are needed to guide episiotomy practice.
我们的目标是评估以色列医院所采用的会阴切开术技术，确定影响切口参数的因素，并查阅最新的相关专业文献。
从2013年10月开始，在以色列北部的四家公立医院，使用匿名问卷对产科医生和助产士进行了为期1年的调查。除了人口统计学和专业数据外，还要求接生者描述他们通常用于进行会阴切开术的技术（长度、角度以及起始点与会阴中点的距离）。
总体而言，84名产科医生和32名助产士参与了调查。只有37.6%的人报告进行了中侧切开术，其余的人描述为侧切术，起始点平均距离阴唇系带2.45±0.88厘米。与助产士相比，产科医生报告的会阴切开术明显更长（3.53±1.01厘米对2.73±0.81厘米，p = 0.0002）。
根据我们的研究和相关文献综述，会阴切开术技术在卫生专业人员之间存在显著差异，并且与国际实践指南并不完全一致。部分原因在于文献证据不明确，以及国家指南对该手术正确技术缺乏共识定义。因此，需要进一步开展更高质量的研究、统一方案和教育项目来指导会阴切开术的实践。
