Dimitrov A, Nikolov A, Nalbanski B, Stamenov G, Dimitrov I, Lazarova L, Gamishev G
Akush Ginekol (Sofiia). 1997;36(1):3-4.
The purpose is to asses the effect of restrictive use of mediolateral episiotomy on the spontaneous laceration of the low birth canal. The material includes 613 labors some of which gave birth with indication for episiotomy and control group of 441 retrospective cases with routine management of the second period of labor. The restrictive use of episiotomy decreases the rate from 45.6% in the routine practice to 32.8%. The reduced rate of episiotomy has as a consequent increase rate of second degree perineal laceration adn insignificant increase of vaginal lacerations. The management of restrictive and liberal use of mediolateral episiotomy has not effect on third and four degree perineal laceration, on the accessory tears of the vagina and on the rate of perineotomy. If from all labors are subtracted operative deliveries, surgical intervention for repairing the laceration of the birth canal and pathology of the placental period the rate of labors without any intervention is only 13.3%. Our results suggest that labor nowadays is operative activity.
目的是评估限制性使用会阴侧切术对低位产道自然裂伤的影响。研究材料包括613例分娩病例，其中一些病例因有会阴侧切术指征而进行分娩，对照组为441例回顾性病例，采用第二产程常规处理。会阴侧切术的限制性使用使该比率从常规操作中的45.6%降至32.8%。会阴侧切率的降低随之而来的是二度会阴裂伤发生率的增加以及阴道裂伤的轻微增加。限制性和宽松性使用会阴侧切术的处理方式对三度和四度会阴裂伤、阴道副裂伤以及会阴切开率没有影响。如果从所有分娩中减去手术分娩、修复产道裂伤的手术干预以及胎盘期病理情况，无任何干预的分娩率仅为13.3%。我们的结果表明，如今的分娩是一种手术行为。
