Gachon B, Charveriat A, Pierre F, Fritel X
Service de gynécologie obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France; Laboratoire « Mouvement, Interactions, Performance » EA 4334, Faculté des sciences du sport, Université de Nantes, 25, boulevard Guy-Mollet, 44322 Nantes, France; Centre d'investigation clinique pluri-thématique du CHU de Poitiers, Inserm 1402, 2, rue de la Milétrie, 86000 Poitiers, France.
Service de gynécologie obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
Gynecol Obstet Fertil Senol. 2019 Sep;47(9):627-636. doi: 10.1016/j.gofs.2019.06.011. Epub 2019 Jun 27.
The main endpoint was to perform a survey about the practices of episiotomy into a CNGOF (National College of French Obstetricians and Gynecologists) members population.
In November 2018, it was proceeded to a national survey from CNGOF members thanks to an online questionnaire. We collected prospectively: the answerer's characteristics, the rate of episiotomy and its systematics indications for spontaneous and operative delivery, the habits of the practitioners for the section and the reparation, the modalities of women's information and the data entered into the medical record.
Three hundred and eighty nine CNGOF members answered to the survey. They were 69% to declare performing less than 10% of episiotomy in case of spontaneous vertex delivery. The most frequent systematic indication of episiotomy was the personal history of obstetric anal sphincter injury (more than 30% of answerers). Systematic episiotomy was less frequent in case of vacuum assisted operative delivery compared to forceps (OR=0.18 [0.08-0.37]) or spatulas (OR=0.28 [0.12-0.59]). Most of practitioners (94%) declared performing mediolateral episiotomies, 64% declared cutting with an equal or more than 45° angle and 50% declared using a resorbable continuous suture technique for the reparation. Half of the answerers (46%) indicated that they inform et collected women's consent before performing an episiotomy.
Several practices, women's information, section angle and the reparation technique are subject to change by the latest 2018 CNGOF guidelines about perineal protection.
主要终点是对法国国家妇产科医师学院（CNGOF）成员群体进行会阴切开术实践的调查。
2018年11月，通过在线问卷对CNGOF成员进行了全国性调查。我们前瞻性地收集了：回答者的特征、会阴切开术的比例及其在自然分娩和手术分娩中的系统指征、从业者进行切开和修复的习惯、向女性提供信息的方式以及录入病历的数据。
389名CNGOF成员回答了调查。69%的人宣称在自然头位分娩时会阴切开术的实施比例低于10%。会阴切开术最常见的系统指征是产科肛门括约肌损伤的个人史（超过30%的回答者）。与产钳（OR = 0.18 [0.08 - 0.37]）或胎头吸引器（OR = 0.28 [0.12 - 0.59]）辅助的手术分娩相比，真空辅助手术分娩时系统性会阴切开术的频率较低。大多数从业者（94%）宣称进行侧斜切开术，64%宣称以等于或大于45°的角度切开，50%宣称在修复时使用可吸收连续缝合技术。一半的回答者（46%）表示他们在进行会阴切开术前告知并征得女性同意。
根据2018年CNGOF最新的会阴保护指南，一些实践、向女性提供信息的方式、切开角度和修复技术可能会发生变化。
