Cargando…
A multicenter cross‐sectional study of episiotomy practice in Romania
RATIONALE, AIMS, AND OBJECTIVES: The aim of this study was to focus attention on episiotomy practice in Romanian maternity units in order to identify factors associated with the very high rate of the procedure in Romania and to consider strategies to reduce it. METHODS: In this clustered cross‐secti...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587480/ https://www.ncbi.nlm.nih.gov/pubmed/30426613 http://dx.doi.org/10.1111/jep.13062 |
_version_ | 1783429074779111424 |
---|---|
author | Pasc, Andrada Navolan, Dan Pușcașiu, Lucian Ionescu, Cringu Antoniu Szasz, Florin Adrian Carabineanu, Adrian Dimitriu, Mihai Călin, Daniel Bohilțea, Roxana Ples, Liana Nemescu, Dragoș |
author_facet | Pasc, Andrada Navolan, Dan Pușcașiu, Lucian Ionescu, Cringu Antoniu Szasz, Florin Adrian Carabineanu, Adrian Dimitriu, Mihai Călin, Daniel Bohilțea, Roxana Ples, Liana Nemescu, Dragoș |
author_sort | Pasc, Andrada |
collection | PubMed |
description | RATIONALE, AIMS, AND OBJECTIVES: The aim of this study was to focus attention on episiotomy practice in Romanian maternity units in order to identify factors associated with the very high rate of the procedure in Romania and to consider strategies to reduce it. METHODS: In this clustered cross‐sectional study, a total of 11 863 patients were recorded in eight Romanian maternity units to assess the prevalence of episiotomy. A random effects Poisson model was used to estimate the prevalence rate in univariate and multivariate models. RESULTS: Among the 11 863 patients included for analysis, 8475 (71.4%) had an episiotomy. The prevalence of episiotomy was 92.7% for the first vaginal birth, 73.2% for the second vaginal birth, and 35% for the third vaginal birth. The overall rate of suturing was higher than the episiotomy rate for all patients (total rate 79.2%). The likelihood of exiting the maternity ward with an intact perineum after the first vaginal birth was less than 5% at the first vaginal birth. CONCLUSIONS: In conclusion, routine episiotomy is the norm in Romanian maternity units, with episiotomy rates among the highest in Europe. Episiotomy use is mainly driven by local professional norms, experiences, previous training, and practitioners' decisions rather than evidence, guidelines, or variations in patient needs at the time of vaginal birth. |
format | Online Article Text |
id | pubmed-6587480 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-65874802019-07-02 A multicenter cross‐sectional study of episiotomy practice in Romania Pasc, Andrada Navolan, Dan Pușcașiu, Lucian Ionescu, Cringu Antoniu Szasz, Florin Adrian Carabineanu, Adrian Dimitriu, Mihai Călin, Daniel Bohilțea, Roxana Ples, Liana Nemescu, Dragoș J Eval Clin Pract Original Papers RATIONALE, AIMS, AND OBJECTIVES: The aim of this study was to focus attention on episiotomy practice in Romanian maternity units in order to identify factors associated with the very high rate of the procedure in Romania and to consider strategies to reduce it. METHODS: In this clustered cross‐sectional study, a total of 11 863 patients were recorded in eight Romanian maternity units to assess the prevalence of episiotomy. A random effects Poisson model was used to estimate the prevalence rate in univariate and multivariate models. RESULTS: Among the 11 863 patients included for analysis, 8475 (71.4%) had an episiotomy. The prevalence of episiotomy was 92.7% for the first vaginal birth, 73.2% for the second vaginal birth, and 35% for the third vaginal birth. The overall rate of suturing was higher than the episiotomy rate for all patients (total rate 79.2%). The likelihood of exiting the maternity ward with an intact perineum after the first vaginal birth was less than 5% at the first vaginal birth. CONCLUSIONS: In conclusion, routine episiotomy is the norm in Romanian maternity units, with episiotomy rates among the highest in Europe. Episiotomy use is mainly driven by local professional norms, experiences, previous training, and practitioners' decisions rather than evidence, guidelines, or variations in patient needs at the time of vaginal birth. John Wiley and Sons Inc. 2018-11-13 2019-04 /pmc/articles/PMC6587480/ /pubmed/30426613 http://dx.doi.org/10.1111/jep.13062 Text en © 2018 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Papers Pasc, Andrada Navolan, Dan Pușcașiu, Lucian Ionescu, Cringu Antoniu Szasz, Florin Adrian Carabineanu, Adrian Dimitriu, Mihai Călin, Daniel Bohilțea, Roxana Ples, Liana Nemescu, Dragoș A multicenter cross‐sectional study of episiotomy practice in Romania |
title | A multicenter cross‐sectional study of episiotomy practice in Romania |
title_full | A multicenter cross‐sectional study of episiotomy practice in Romania |
title_fullStr | A multicenter cross‐sectional study of episiotomy practice in Romania |
title_full_unstemmed | A multicenter cross‐sectional study of episiotomy practice in Romania |
title_short | A multicenter cross‐sectional study of episiotomy practice in Romania |
title_sort | multicenter cross‐sectional study of episiotomy practice in romania |
topic | Original Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587480/ https://www.ncbi.nlm.nih.gov/pubmed/30426613 http://dx.doi.org/10.1111/jep.13062 |
work_keys_str_mv | AT pascandrada amulticentercrosssectionalstudyofepisiotomypracticeinromania AT navolandan amulticentercrosssectionalstudyofepisiotomypracticeinromania AT puscasiulucian amulticentercrosssectionalstudyofepisiotomypracticeinromania AT ionescucringuantoniu amulticentercrosssectionalstudyofepisiotomypracticeinromania AT szaszflorinadrian amulticentercrosssectionalstudyofepisiotomypracticeinromania AT carabineanuadrian amulticentercrosssectionalstudyofepisiotomypracticeinromania AT dimitriumihai amulticentercrosssectionalstudyofepisiotomypracticeinromania AT calindaniel amulticentercrosssectionalstudyofepisiotomypracticeinromania AT bohiltearoxana amulticentercrosssectionalstudyofepisiotomypracticeinromania AT plesliana amulticentercrosssectionalstudyofepisiotomypracticeinromania AT nemescudragos amulticentercrosssectionalstudyofepisiotomypracticeinromania AT pascandrada multicentercrosssectionalstudyofepisiotomypracticeinromania AT navolandan multicentercrosssectionalstudyofepisiotomypracticeinromania AT puscasiulucian multicentercrosssectionalstudyofepisiotomypracticeinromania AT ionescucringuantoniu multicentercrosssectionalstudyofepisiotomypracticeinromania AT szaszflorinadrian multicentercrosssectionalstudyofepisiotomypracticeinromania AT carabineanuadrian multicentercrosssectionalstudyofepisiotomypracticeinromania AT dimitriumihai multicentercrosssectionalstudyofepisiotomypracticeinromania AT calindaniel multicentercrosssectionalstudyofepisiotomypracticeinromania AT bohiltearoxana multicentercrosssectionalstudyofepisiotomypracticeinromania AT plesliana multicentercrosssectionalstudyofepisiotomypracticeinromania AT nemescudragos multicentercrosssectionalstudyofepisiotomypracticeinromania |