在阴道助产术中，会阴正中切开术会增加Ⅲ度和Ⅳ度会阴裂伤的风险吗？
Does midline episiotomy increase the risk of third- and fourth-degree lacerations in operative vaginal deliveries?
作者信息
Helwig J T, Thorp J M, Bowes W A
机构信息
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill.
出版信息
Obstet Gynecol. 1993 Aug;82(2):276-9.
OBJECTIVE
To explore the association between midline episiotomy and the risk of third- and fourth-degree lacerations during operative vaginal delivery with either vacuum extractor or forceps.
METHODS
This retrospective cohort study analyzed all operative vaginal deliveries at a university hospital in 1989 and 1990. Univariate analysis of the relationships between perineal lacerations and obstetric variables was performed. Stratified analysis using the relevant variables was used to calculate relative risk (RR) estimates.
RESULTS
Episiotomy, birth weight, and whether the index birth was the first vaginal birth were associated with third- and fourth-degree perineal lacerations. Stratified analysis demonstrated an RR of 2.4 with a 95% confidence interval of 1.7-3.5 for rectal injury with episiotomy, adjusting for parity and birth weight.
CONCLUSION
Midline episiotomy is associated with an increased risk of third- and fourth-degree perineal lacerations in operative vaginal deliveries.
目的
探讨在使用真空吸引器或产钳进行阴道助产时，会阴正中切开术与三度和四度会阴裂伤风险之间的关联。
方法
这项回顾性队列研究分析了1989年和1990年在一家大学医院进行的所有阴道助产分娩。对会阴裂伤与产科变量之间的关系进行了单因素分析。使用相关变量进行分层分析以计算相对风险（RR）估计值。
结果
会阴切开术、出生体重以及本次分娩是否为首次阴道分娩与三度和四度会阴裂伤有关。分层分析显示，在调整了产次和出生体重后，会阴切开术导致直肠损伤的RR为2.4，95%置信区间为1.7 - 3.5。
结论
在阴道助产分娩中，会阴正中切开术与会阴三度和四度裂伤风险增加有关。
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