Department of Obstetrics and Gynaecology, Peterborough City Hospital, North West Anglia Foundation NHS trust, Peterborough, UK.
Department of Obstetrics and Gynaecology, Hinchingbrooke Hospital, North West Anglia Foundation NHS Trust, Huntingdon, UK.
Int Urogynecol J. 2020 Sep;31(9):1729-1734. doi: 10.1007/s00192-019-04201-7. Epub 2020 Jan 31.
This time-series analysis was carried out to determine if the use of the EPISCISSORS-60®, episiotomy scissors specifically designed to achieve a cutting angle of 60°, would continue to sustain obstetric anal sphincter injuries (OASIS) reductions at our hospital 2 years after its introduction.
We compared data from 2,342 women delivered in 2014 (prior to the introduction of EPISCISSORS-60®) with that of 4,498 women delivered from 2016 to 2017 (after the introduction of EPISCISSORS-60®).
There was a reduction of OASIS in all nulliparous vaginal deliveries (NVD; 7.2% vs 5.1% p = 0.05), and a 50% reduction of OASIS (7.5% vs 3.7%) in operative vaginal deliveries (OVD) (p = 0.02). There was a statistically significant association between episiotomies performed with EPISCISSORS-60® and a reduction in OASIS (SVD: 6.9% vs 1.5% p = 0.006; OVD:28.6% vs 2.6% p < 0.0001). Additionally, there was an increase in the use of episiotomies in all nulliparous vaginal deliveries (29% vs 33.7%; p = 0.01). We also found a 78% reduction of OASIS with episiotomies compared with no episiotomies in the 2016-2017 group (6.9% vs 1.5% p = 0.006).
Our results suggest that there might have been a sustained reduction in OASIS rates associated with using EPISCISSORS-60®.
本时间序列分析旨在确定在引入 EPISCISSORS-60 ® 特定设计的侧切剪以实现 60°侧切角度后，我们医院是否会继续降低产科肛门括约肌损伤 (OASIS) 的发生率。
我们比较了 2014 年（在 EPISCISSORS-60 ® 引入之前）2342 名产妇和 2016 年至 2017 年（在 EPISCISSORS-60 ® 引入之后）4498 名产妇的数据。
所有初产妇的阴道分娩 (NVD) 中 OASIS 发生率降低（7.2%比 5.1%，p=0.05），阴道助产分娩 (OVD) 中 OASIS 发生率降低 50%（7.5%比 3.7%，p=0.02）。使用 EPISCISSORS-60 ® 行会阴切开术与 OASIS 发生率降低显著相关（SVD：6.9%比 1.5%，p=0.006；OVD：28.6%比 2.6%，p<0.0001）。此外，在所有初产妇的阴道分娩中，会阴切开术的使用率增加（29%比 33.7%，p=0.01）。我们还发现，与 2016-2017 年组中无会阴切开术相比，会阴切开术的 OASIS 发生率降低了 78%（6.9%比 1.5%，p=0.006）。
我们的结果表明，使用 EPISCISSORS-60 ® 可能会持续降低 OASIS 发生率。
