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Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial

BACKGROUND: World Health Organization (WHO) recommends that the episiotomy rate should be around 10%, which is already a reality in many European countries. Currently the use of episiotomy should be restricted and physicians are encouraged to use their clinical judgment to decide when the procedure...

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Autores principales: Melo, Inês, Katz, Leila, Coutinho, Isabela, Amorim, Melania Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142063/
https://www.ncbi.nlm.nih.gov/pubmed/25124938
http://dx.doi.org/10.1186/1742-4755-11-66
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author Melo, Inês
Katz, Leila
Coutinho, Isabela
Amorim, Melania Maria
author_facet Melo, Inês
Katz, Leila
Coutinho, Isabela
Amorim, Melania Maria
author_sort Melo, Inês
collection PubMed
description BACKGROUND: World Health Organization (WHO) recommends that the episiotomy rate should be around 10%, which is already a reality in many European countries. Currently the use of episiotomy should be restricted and physicians are encouraged to use their clinical judgment to decide when the procedure is necessary. There is no clinical evidence corroborating any indication of episiotomy, so until the present moment it is not yet known whether episiotomy is indeed necessary in any context of obstetric practice. OBJECTIVES: To compare maternal and perinatal outcomes in women undergoing a protocol of not performing episiotomy versus selective episiotomy. METHODS/DESIGN: An open label randomized clinical trial will be conducted including laboring women with term pregnancy, maximum dilation of 8 cm, live fetus in cephalic vertex presentation. Women with bleeding disorders of pregnancy, indication for caesarean section and those without capacity to consent and without legal guardians will be excluded. Primary outcomes will be frequency of episiotomy, delivery duration, frequency of spontaneous lacerations and perineal trauma, frequency of instrumental delivery, postpartum blood loss, need for perineal suturing, number of sutures, Apgar scores at one and five minutes, need for neonatal resuscitation and pH in cord blood. As secondary outcomes frequency complications of perineal suturing, postpartum perineal pain, maternal satisfaction, neonatal morbidity and admission newborn in NICU will be assessed. Women will be invited to participate and those who agree will sign the consent form and will be then assigned to a protocol of not conducting episiotomy (experimental group) or to a group that episiotomy is performed selectively according to the judgment of the provider of care delivery (control Group). The present study was approved by IMIP’s Research Ethics Committee. TRIAL REGISTRATION: Clinical Trials Register under the number and was registered in ClinicalTrials.gov under the number NCT02178111.
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spelling pubmed-41420632014-08-24 Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial Melo, Inês Katz, Leila Coutinho, Isabela Amorim, Melania Maria Reprod Health Study Protocol BACKGROUND: World Health Organization (WHO) recommends that the episiotomy rate should be around 10%, which is already a reality in many European countries. Currently the use of episiotomy should be restricted and physicians are encouraged to use their clinical judgment to decide when the procedure is necessary. There is no clinical evidence corroborating any indication of episiotomy, so until the present moment it is not yet known whether episiotomy is indeed necessary in any context of obstetric practice. OBJECTIVES: To compare maternal and perinatal outcomes in women undergoing a protocol of not performing episiotomy versus selective episiotomy. METHODS/DESIGN: An open label randomized clinical trial will be conducted including laboring women with term pregnancy, maximum dilation of 8 cm, live fetus in cephalic vertex presentation. Women with bleeding disorders of pregnancy, indication for caesarean section and those without capacity to consent and without legal guardians will be excluded. Primary outcomes will be frequency of episiotomy, delivery duration, frequency of spontaneous lacerations and perineal trauma, frequency of instrumental delivery, postpartum blood loss, need for perineal suturing, number of sutures, Apgar scores at one and five minutes, need for neonatal resuscitation and pH in cord blood. As secondary outcomes frequency complications of perineal suturing, postpartum perineal pain, maternal satisfaction, neonatal morbidity and admission newborn in NICU will be assessed. Women will be invited to participate and those who agree will sign the consent form and will be then assigned to a protocol of not conducting episiotomy (experimental group) or to a group that episiotomy is performed selectively according to the judgment of the provider of care delivery (control Group). The present study was approved by IMIP’s Research Ethics Committee. TRIAL REGISTRATION: Clinical Trials Register under the number and was registered in ClinicalTrials.gov under the number NCT02178111. BioMed Central 2014-08-14 /pmc/articles/PMC4142063/ /pubmed/25124938 http://dx.doi.org/10.1186/1742-4755-11-66 Text en Copyright © 2014 Melo et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Melo, Inês
Katz, Leila
Coutinho, Isabela
Amorim, Melania Maria
Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
title Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
title_full Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
title_fullStr Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
title_full_unstemmed Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
title_short Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
title_sort selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142063/
https://www.ncbi.nlm.nih.gov/pubmed/25124938
http://dx.doi.org/10.1186/1742-4755-11-66
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