Carrera de Obstetricia, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito (Ecuador).
Carrera de Obstetricia, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito (Ecuador). Servicio de Neonatología, Hospital Gineco Obstétrico Isidro Ayora, Quito (Ecuador).
Rev Colomb Obstet Ginecol. 2024 Jul 9;75(2):4216. doi: 10.18597/rcog.4216.
To determine the prevalence of episiotomy over a 14-year period and to explore its association with maternal, delivery, and neonatal variables using administrative data.
This is a cross-sectional study. Women who had a vaginal delivery with a live newborn at a referral hospital for obstetric care in Ecuador were included. Consecutive sampling was employed. ICD-10 records and the perinatal information system (PIS) were utilized. Sociodemographic, gestational, delivery, and neonatal variables were assessed. Descriptive analysis was performed. The overall and yearly prevalence was determined. Exploratory bivariate and multivariate analyses were conducted. The study was approved by the Human Research Ethics Committee of the Universidad Central del Ecuador.
A total of 11,862 records were analyzed. The overall prevalence of episiotomy was 36.69 %, with a maximum of 42 % and a minimum of 28 %. There is an implied trend towards a reduction in frequency from 2019 to 2022. A positive association was found between episiotomy and maternal age under 20 years, previous cesarean section, absence of a companion during delivery, term newborns, and large for gestational age newborns. A negative association was found with previous vaginal deliveries.
The prevalence of episiotomy exceeds the recommendation of the World Health Organization (WHO). Clinical practice guidelines should consider potentially modifiable maternal and neonatal factors in their recommendations. Prospective studies should be conducted to evaluate the safety of the procedure, confirm these observations, and use robust methodologies to assess if there is a real decrease in its practice.
利用行政数据确定 14 年来会阴切开术的流行率，并探讨其与产妇、分娩和新生儿变量的关系。
这是一项横断面研究。纳入厄瓜多尔一家产科转诊医院阴道分娩并有活产新生儿的妇女。采用连续抽样法。使用 ICD-10 记录和围产期信息系统（PIS）。评估社会人口统计学、妊娠、分娩和新生儿变量。进行描述性分析。确定总体和年度流行率。进行探索性双变量和多变量分析。该研究得到厄瓜多尔中央大学人类研究伦理委员会的批准。
共分析了 11862 份记录。会阴切开术的总体流行率为 36.69%，最高为 42%，最低为 28%。从 2019 年到 2022 年，频率呈下降趋势。会阴切开术与 20 岁以下产妇、既往剖宫产、分娩时无陪伴、足月新生儿和大于胎龄儿呈正相关。与既往阴道分娩呈负相关。
会阴切开术的流行率超过世界卫生组织（WHO）的建议。临床实践指南应在其建议中考虑潜在可改变的产妇和新生儿因素。应进行前瞻性研究，以评估该手术的安全性，确认这些观察结果，并使用稳健的方法评估其实际应用是否有所减少。
