Berthet J, Buchet A, Favier M, Racinet C
Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Sud, CHRU de Grenoble.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(4):419-23.
A retrospective study of case controls was carried out by postal enquiry to find out the risk factors for complete complicated tears (DCC) of the perineum occurring after prophylactic episiotomy. There were 33 such cases of DCC out of 8,039 vaginal deliveries which means 0.41% in the University Centre in Grenoble in the years 1985-1986-1987. A control group of 66 cases was paired according to parity and episiotomy. The risk factors were identified as large fetal weight, instrumental deliveries, mid-line episiotomy or perineotomy. The questionnaires could be analysed for faults after delivery in 26 cases and 52 controls (response rate of 90%). The sole significant problem of the cases was perineal and rectal pain lasting more than a month longer than in the control cases. There was no greater dyspareunia, stress incontinence with urine, nor anal incontinence which contradicts previous reports in the literature. The authors conclude there are no serious complications of DCC following perineotomy providing repair is carried out very carefully. The patients in this group show that is was acceptable because no more in this group than in the controls were frightened of a repeat pregnancy.
通过邮政调查对病例对照进行了一项回顾性研究，以找出预防性会阴切开术后发生会阴完全复杂撕裂（DCC）的风险因素。在1985 - 1986 - 1987年期间，格勒诺布尔大学中心的8039例阴道分娩中有33例发生了这种DCC，占0.41%。根据产次和会阴切开术情况配对了一个由66例病例组成的对照组。风险因素被确定为胎儿体重过大、器械助产、中线会阴切开术或会阴切开术。产后对26例病例和52例对照的问卷进行了分析（回复率为90%）。病例组唯一显著的问题是会阴和直肠疼痛持续时间比对照组多一个多月。没有更严重的性交困难、压力性尿失禁或肛门失禁，这与文献中先前的报道相矛盾。作者得出结论，只要修复非常仔细，会阴切开术后DCC不会有严重并发症。该组患者表明这是可以接受的，因为该组中害怕再次怀孕的人数并不比对照组多。
