Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, NE1 4LP, UK.
Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, NE1 4LP, UK.
Eur J Obstet Gynecol Reprod Biol. 2019 Oct;241:94-98. doi: 10.1016/j.ejogrb.2019.08.016. Epub 2019 Aug 27.
To investigate the impact of the Episcissors-60 on obstetric anal sphincter injury (OASI) rates.
Observational multi-centre time series analysis at four maternity units in the North-East of England. The main outcome measures were obstetric anal sphincter injury rates and delivery blood loss.
Data were analysed for women who had a vaginal birth of a singleton pregnancy before (11,192) and after (8064) the introduction of the Episcissors-60. There were 2115 episiotomies before and 1498 after the introduction of the Episcissors-60, of which 1311 (87.5%) were undertaken with the Episcissors-60, 114 (7.6%) with other scissors and the scissors used were not stated in 73 (4.8%) women. There was no significant association between the introduction of Episcissors-60 and the performance of an episiotomy (χ = 0.006, p = 0.94). Episiotomy was associated with a significant reduction in OASI rates (1.9% Vs 2.8%, odds ratio = 0.67 [0.51 - 0.86]; p = 0.001). There was no significant association between the introduction of the Episcissors-60 and the occurrence of OASIs in all women (χ = 0.6, p = 0.46) or in women who had an episiotomy (χ = 0.20, p = 0.71). In women who had an episiotomy, the mean estimated delivery blood loss was 550.3 ± 8.2 ml before and 598.8 ± 10.9 ml after the introduction of the Episcissors-60 (p < 0.001).
Introduction of the Episcissors-60 was not associated with a change in OASI or episiotomy rates but may be associated with a small increase in delivery blood loss.
探讨 Episcissors-60 对产科肛门括约肌损伤（OASI）发生率的影响。
在英格兰东北部的 4 家产科单位进行观察性多中心时间序列分析。主要结局指标为产科肛门括约肌损伤发生率和分娩失血量。
对阴道分娩单胎妊娠的产妇进行数据分析，在 Episcissors-60 引入前（11192 例）和引入后（8064 例）。在 Episcissors-60 引入前有 2115 例会阴切开术，引入后有 1498 例，其中 1311 例（87.5%）采用 Episcissors-60 进行，114 例（7.6%）采用其他剪刀，73 例（4.8%）未说明使用的剪刀类型。Episcissors-60 的引入与会阴切开术的实施之间无显著关联（χ²=0.006，p=0.94）。会阴切开术与 OASI 发生率显著降低相关（1.9%比 2.8%，比值比=0.67[0.51-0.86]；p=0.001）。Episcissors-60 的引入与所有女性 OASI 的发生之间无显著关联（χ²=0.6，p=0.46）或与接受会阴切开术的女性之间无显著关联（χ²=0.20，p=0.71）。在接受会阴切开术的女性中，Episcissors-60 引入前的平均估计分娩失血量为 550.3±8.2ml，引入后为 598.8±10.9ml（p<0.001）。
Episcissors-60 的引入与 OASI 或会阴切开术发生率的变化无关，但可能与分娩失血量的少量增加有关。
