Sagi-Dain L, Sagi S
a Department of Obstetrics and Gynaecology , Carmel Medical Center , Haifa , Israel.
b Genetics Institute, HaEmek Medical Center , Afula , Israel.
J Obstet Gynaecol. 2016;36(3):361-5. doi: 10.3109/01443615.2015.1065233. Epub 2015 Oct 14.
Our objective was to assess the reported reasons for episiotomy performance in Israel and to review the relevant professional literature. Using anonymous questionnaires, a survey was conducted among obstetricians and midwives in four northern Israel hospitals, and the accoucheurs were asked to score their agreement with 13 proposed indications for episiotomy. Overall, 84 doctors and 32 midwives completed the questionnaires. 86.1% of the responders reported performing episiotomy in all or most cases of shoulder dystocia, and more than half reported performing it in most cases of vacuum deliveries, fetal macrosomia and advanced perineal tear in previous delivery. Subjective assessment of perineal characteristics constituted a justified reason for episiotomy for 15.8-43.9% of the accoucheurs. In conclusion, there is a wide variation in reported reasons for episiotomy between the obstetricians, and many of these indications are not congruent with international practice guidelines. Uniform protocols and educational programmes are needed to guide episiotomy practice.
我们的目标是评估以色列报道的会阴切开术实施原因，并回顾相关专业文献。通过使用匿名问卷，对以色列北部四家医院的产科医生和助产士进行了一项调查，并要求接生者对13条提出的会阴切开术指征的认同程度进行评分。总体而言，84名医生和32名助产士完成了问卷。86.1%的受访者报告在所有或大多数肩难产病例中实施会阴切开术，超过一半的人报告在大多数真空分娩、巨大儿和既往分娩时会阴Ⅲ度裂伤的病例中实施该手术。15.8%至43.9%的接生者认为，对会阴特征的主观评估是实施会阴切开术的合理理由。总之，产科医生报告的会阴切开术原因存在很大差异，其中许多指征与国际实践指南不一致。需要统一的方案和教育计划来指导会阴切开术的实施。
