Clesse Christophe, Lighezzolo-Alnot Joëlle, De Lavergne Sylvie, Hamlin Sandrine, Scheffler Michèle
a Interpsy Laboratory (EA4432) , Université de Lorraine, Campus Lettres et Sciences Humaines , Nancy France.
b Jury-Lesmetz , Hospital Centre of Jury-les-Metz , France.
Women Health. 2019 Aug;59(7):760-774. doi: 10.1080/03630242.2018.1553814. Epub 2019 Jan 7.
Episiotomy is an enlargement of the vaginal orifice made by a surgical incision of the perineum. This review aimed to provide a socio-historical retrospective on the practice or episiotomy. Using the criteria from the PRISMA guidelines, the authors conducted a literature review, browsing twenty databases and several papers available in the gray literature. Sixty-four articles, seven reports, and fifteen books were selected. Through this study, four eras with different approaches to episiotomy practice could be identified: 1792-1920, 1920-1980, 1980-1996, and 1996-2018. This review shows that institutionalization and medicalization of birth lead to a systematic practice of episiotomy in many westernized countries until 1996. Lay questioning and evidence-based medicine may have reversed this trend into a restrictive practice. After making an inventory of the factors associated with the evolution of change in the rate of episiotomies, the review finally revealed that evolution of the practice of episiotomy has also been influenced by ideological, political, and social factors.
会阴切开术是指通过会阴的外科手术切口扩大阴道口。本综述旨在对会阴切开术的实施进行社会历史回顾。作者按照系统评价和Meta分析的首选报告项目（PRISMA）指南的标准，进行了文献综述，浏览了20个数据库以及灰色文献中的几篇论文。共筛选出64篇文章、7份报告和15本书籍。通过这项研究，可以确定会阴切开术实施的四个不同阶段：1792年至1920年、1920年至1980年、1980年至1996年以及1996年至2018年。该综述表明，直到1996年，分娩的制度化和医学化导致许多西方国家系统性地实施会阴切开术。外行的质疑和循证医学可能使这一趋势转变为一种限制性做法。在梳理了与会阴切开率变化演变相关的因素后，该综述最终揭示，会阴切开术实施的演变也受到思想、政治和社会因素的影响。
