Borgatta L, Piening S L, Cohen W R
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY 10461.
Am J Obstet Gynecol. 1989 Feb;160(2):294-7. doi: 10.1016/0002-9378(89)90428-6.
Spontaneous deliveries of 241 nulliparous women were analyzed to test the hypothesis that both episiotomy and use of stirrups for delivery of infants were related to the occurrence of third- and fourth-degree perineal lacerations. These deep perineal tears occurred in 0.9% of the women delivered of infants without the use of either episiotomy or stirrups and in 27.9% of the women delivered of infants with both episiotomy and stirrups. Women exposed to episiotomy alone or to stirrups alone had intermediate rates of laceration. There was no independent correlation of laceration with maternal age, 1- and 5-minute Apgar scores, or midwife or physician as delivery attendant. The results suggest that selective use of episiotomy and stirrups can minimize perineal trauma during spontaneous delivery in nulliparous women.
对241名未生育过的女性的自然分娩情况进行了分析，以检验以下假设：会阴切开术和分娩时使用脚蹬与三度和四度会阴撕裂的发生有关。在未使用会阴切开术或脚蹬的情况下分娩的婴儿的女性中，这些深部会阴撕裂的发生率为0.9%；在同时使用会阴切开术和脚蹬分娩的婴儿的女性中，发生率为27.9%。仅接受会阴切开术或仅使用脚蹬的女性的撕裂发生率处于中间水平。撕裂与产妇年龄、1分钟和5分钟阿氏评分或接生人员是助产士还是医生之间没有独立的相关性。结果表明，选择性使用会阴切开术和脚蹬可以将未生育过的女性自然分娩时的会阴创伤降至最低。
