Belay Tamene, Semahegn Agumasie, Mezmur Haymanot, Mulatu Teshale
Department of Midwifery, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
PLOS Glob Public Health. 2024 May 20;4(5):e0003216. doi: 10.1371/journal.pgph.0003216. eCollection 2024.
Maternal morbidity and mortality has remained a major public health concern worldwide. Basic emergency obstetric care is the primary intervention to prevent obstetric complications and maternal death. Episiotomy is one of the basic obstetrical procedures used to facilitate vaginal delivery, shorten the second stage of labor and prevent complications. However, there is a paucity of evidence on the prevalence and factors associated with episiotomy among women who gave birth in eastern Ethiopia.
This study aimed to determine the prevalence of episiotomy and its associated factors among women who gave birth at public health facilities in Jigjiga town, eastern Ethiopia.
A facility-based cross-sectional study was conducted among women who gave birth vaginally from May 1 to June 30, 2022. A total of 422 study participants were recruited using systematic random sampling. Data were collected using structured questionnaires through a face-to-face interview supported with standard observational checklist and reviewing medical records. A logistic regression analysis was carried out to examine the association between explanatory variables and episiotomy. An adjusted odds ratio (AOR) at a 95% confidence interval (CI) at a P-value <0.05 was used to declare significant association.
The prevalence of episiotomy among women was 52.6% (95% CI: 47.8%, 57.0%). Obstetric complications during current pregnancy (AOR:3.92, 95% CI: 1.59, 9.68), birth weight ≥4000 gm (AOR: 4.30, 95% CI: 1.53, 12.04), induction of labor (AOR: 3.10, 95% CI: 1.62, 5.93), meconium-stained amniotic fluid (AOR:2.10, 95% CI: 1.14, 3.88), duration of the second stage of labor ≥90 minutes (AOR:3.09, 95% CI: 1.53, 6.23), instrumental delivery (AOR: 2.69, 95%, CI: 1.39, 5.19), and female genital mutilation (AOR: 2.91, 95% CI: 1.83, 4.64) were factors significantly associated with episiotomy.
Slightly more than half of the women who gave birth at public health facilities in the study area underwent episiotomies. In addition to the common obstetric factors, having a female genital mutilation scar increased the risk of women's experiencing episiotomies. Therefore, intervention should be tailored to address the identified obstetric risk factors and avoid female genital mutilation in the community to reduce women's experiences of episiotomies in the future.
孕产妇发病率和死亡率一直是全球主要的公共卫生问题。基本急诊产科护理是预防产科并发症和孕产妇死亡的主要干预措施。会阴切开术是用于促进阴道分娩、缩短第二产程并预防并发症的基本产科手术之一。然而，在埃塞俄比亚东部分娩的妇女中，关于会阴切开术的患病率及其相关因素的证据很少。
本研究旨在确定埃塞俄比亚东部吉吉加镇公共卫生设施中分娩妇女会阴切开术的患病率及其相关因素。
2022年5月1日至6月30日，对在公共卫生设施阴道分娩的妇女进行了一项基于机构的横断面研究。采用系统随机抽样方法，共招募了422名研究参与者。通过结构化问卷，在标准观察检查表和查阅病历的支持下，进行面对面访谈收集数据。进行逻辑回归分析，以检验解释变量与会阴切开术之间的关联。采用95%置信区间（CI）的调整比值比（AOR），P值<0.05时宣布存在显著关联。
妇女会阴切开术的患病率为52.6%（95%CI：47.8%，57.0%）。本次妊娠期间的产科并发症（AOR：3.92，95%CI：1.59，9.68）、出生体重≥4000克（AOR：4.30，95%CI：1.53，12.04）、引产（AOR：3.10，95%CI：1.62，5.93）、羊水粪染（AOR：2.10，95%CI：1.14，3.88）、第二产程持续时间≥90分钟（AOR：3.09，95%CI：1.53，6.23）、器械助产（AOR：2.69，95%CI：1.39，5.19）以及女性生殖器切割（AOR：2.91，95%CI：1.83，4.64）是与会阴切开术显著相关的因素。
在研究地区公共卫生设施分娩的妇女中，略多于一半的人接受了会阴切开术。除了常见的产科因素外，有女性生殖器切割疤痕会增加妇女接受会阴切开术的风险。因此，应针对性地采取干预措施，以解决已确定的产科危险因素，并避免社区中的女性生殖器切割，以减少未来妇女接受会阴切开术的情况。
