贡达尔大学综合专科转诊医院会阴切开术的患病率及其 相关因素：来自埃塞俄比亚的回顾性研究

Yonas Teshome¹, Amanuael Mengistu¹, Sisay Shewasinad¹, Negese Worku¹, Mengistu Mekonen², Tariku Sisay³, Getahun Chala⁴
1、德布雷 · 伯尔汉 德布雷 · 伯尔汉大学医学院生物医学系
2、贡达尔大学医学与健康科学学院护理系
3、赞特皮大学健康科学学院生物医学系
4、哈拉梅亚大学健康与医学科学学院生理学系
5、德布雷 · 贝尔汉 德布雷 · 贝尔汉医院内科
6、德布雷 · 贝尔汉 德布雷 · 伯尔汉大学健康科学学院护理系

摘要

背景：会阴切开术是一种在分娩过程中对会阴进行扩大阴道口的手术切口。它是世界上最常见的产科干预之一。
会阴切开的程度因人群而异。与埃塞俄比亚会阴切开术实践相关的信息有限。这项研究旨在评估埃塞俄比亚贡达尔大学综
合专业转诊医院会阴切开术的患病率及其相关因素。方法：2014 年 3 月至 6 月，对 306 名在医院进行阴道分娩的母亲进行
了基于机构的回顾性横断面研究。采用系统随机抽样技术选择研究单位。使用预先测试的脸颊列表收集数据。计算会阴切
开术患者的比例，并使用二元和多元逻辑回归和卡方检验因变量和自变量之间的相关性。结果：冈达尔大学综合专科转诊
医院会阴切开术的患病率为 47.7%（n=146）。大多数分娩（89.5%）是自发阴道分娩，而真空分娩、产钳分娩和破坏性分
娩分别为 4.6%、4.6% 和 1.3%。在怀孕和分娩期间，84% 的母亲没有相关疾病，8% 的母亲患有高血压疾病，5% 的母亲患
有糖尿病，3% 的母亲患有其他疾病。经多变量分析，会阴切开术与产妇年龄（15-24 岁）（p=0.041，AOR（CI 95%）1.65
（1.02-2.66））、初产（p=0.010，AOR）2.61（1.54-4.44））、产程延长（p=0.001，结论：该机构会阴切开术的患病率为
47.7%，与会阴切开术显著相关的变量为产妇年龄、初产、分娩时间和新生儿体重。

关键词

会阴切开术；初产；会阴；长期劳动

参考

[1] Carroli G and Mignini L. Episiotomy for vaginal birth.

Cochrane Database Syst Rev. 2012; (1). doi: 10.1002/14651858.

CD000081.pub2.

[2] Klein M. Rites of Passage: Episiotomy and the Second

Stage of Labour. Can Fam Physiology. 1988; 34: 2019-2025.

[3] Lappen, J. R., and Gossett, D. R. Changes in

episiotomy practice: Evidence-based medicine in action. Expert

Review of Obstetrics and Gynecology. 2010; 5 (3): 301-309.

[4] Bertozzi S, Londero A, Fruscalzo A et. al. Impact

of episiotomy on pelvic floor disorders and their influence

on women’s wellness after the sixth month postpartum: a

retrospective study. BMC. Women’s Health. 2011; 11: 12.

[5] Kumar S, Singh S, Babu K M, Halesha B, and Vikas S.

Restricted use of Episiotomy. J Obstet Gynecol India. 2010; 60

(5): 408 – 412.

[6] Kutuk M, Dolanbay M, Ozgun M, Ozdemir F, Ozturk

A, and Aygen E. Retrospective Analysis of Episiotomy Rate

inErciyes University. Gynecol Obstet Reprod Med. 2014; 20:

10-14.

[7] Sayasneh A and Pandeva I. Postpartum sexual

dysfunction: a literature review of risk factors and role of mode

of delivery. BJMP. 2010; 3 (2): 316-321.

[8] Signorello, L. B. Midline episiotomy and anal

incontinence: retrospective cohort study. BMJ, 2000; 320

(7227): 86–90. doi: 10.1136/bmj.320.7227.86.

[9] Alzahrani H. Does episiotomy prevent perineal trauma?

MIDIRS Midwifery Digest. 2014; 24 (4): 478–483.

[10] Hsieh W, Liang C, Wu D, Chang S, Chueh H, and

Chao A. Prevalence and contributing factors of severe perineal

damage following episiotomy-assisted vaginal delivery.

Taiwanese Journal of Obstetrics & Gynecology. 2014; 53: 481-

485.

[11] Raisanen S, Julkunen K, and Heinonen S. Need for

and consequences of episiotomy in vaginal birth: a critical

approach. Midwifery. 2010; 26: 348–356.

[12] Langrová P, and Vrublová Y. Relationship between

episiotomy and prevalence of urinary incontinence in women

2-5 years after childbirth. Cent Eur J Nurs Midw 2014; 5 (3):

94-98.

[13] Hartmann K, Viswanathan M, Palmieri R, Gartlehner

G, Thorp J, and Lohr K. Outcomes of Routine Episiotomy: a

systematic review. JAMA. 2005; 293: 2141-2148.

[14] Melo I., Katz L., Coutinho I., and Amorim M.

Selective episiotomy vs. implementation of a non-episiotomy

protocol: a randomized clinical trial. Reproductive Health.

2014; 11 (1). doi: 10.1186/1742-4755-11-66.

[15] Fodstad K, Staff A and Laine K. Effect of different

episiotomy techniques on perineal pain and sexual activity 3

months after delivery. Int Urogynecol J. 2014. doi: 10.1007/

s00192-014-2401-2.

[16] Fodstad K, Laine K and Staff A. Different episiotomy

techniques, postpartum perineal pain, and blood loss: an

observational study. Int Urogynecol J. 2014. doi: 10.1007/

s00192-012-1960-3.

[17] Allen R and Ronald. Hanson W. Episiotomy in LowRisk Vaginal Deliveries. J Am Board Fam Pract. 2005; 18:

8–12.

[18] Otoide V, Ogbonmwan S, and Okonofua F.

Episiotomy in Nigeria. International Journal of Gynecology &

Obstetrics.2000; 68: 13-17.

[19] Carvalho C, Souza A, and Filho O. Prevalence and

factors associated with practice of episiotomy at a maternity

school in Recife, Pernambuko, Brazil. Rev Assoc Med Bras.

2010; 56 (3): 333-339.

[20] Marai W. A two years retrospective review of

episiotomy at Jimma Teaching Hospital, southwestern Ethiopia.

Ethiop Med J. 2002; 40 (2): 141-148.

[21] Frankman EA, Wang L, Bunker CH, et al. Episiotomy

in the United States: has anything changed? Am J Obstet

Gynecol. 2009; 200: 573-573.

[22] Amorim M, Franca-Neto A, Leal N, Melo F, Maia S,

and Alves J. Is It Possible to Never Perform Episiotomy During

Vaginal Delivery. Obstetrics & Gynecology. 2014; 123: 38.

[23] Trinh, A, Khambalia A, Ampt A, Morris J and Roberts

C. Episiotomy rate in Vietnamese-born women in Australia:

support for a change in obstetric practice in Viet Nam. Bull

World Health Organ. 2013; 91: 350–356. doi: http://dx.doi.

org/10.2471/BLT.12.114314.

[24] Leal N, Amorim M, Franca-Neto A, Leite D, Melo

F, Alves J. Factors Associated With Perineal Lacerations

Requiring Suture in Vaginal Births Without Episiotomy

Obstetrics & Gynecology. 2014; 123: 63–64. doi: 10.1097/01.

AOG.0000447369.00977.4c.

[25] Steiner N., Weintraub A. Y., Wiznitzer, A. et al.

Episiotomy: the final cut? Arch Gynecol Obstet. 2012; 286:

1369. doi: 10.1007/s00404-012-2460-x.

[26] Manzanares S, Cobo D, Martínez M, Mar Sánchez

G, and Pineda A. Risk of episiotomy and perineal lacerations

recurring after first delivery. Birth. 2013; 40 (4): 307–311. doi:

10.1111/birt.12077.

[27] Dame J, Neher J and Safranek S. Does antepartum

perineal massage reduce intrapartum lacerations. Journal of

family practice. 2008; 57 (7): 480-481.

[28] Ho J, Pattanittum P, Japaraj R, Turner T, Swadpanich

U, and Crowther C. Influence of training in the use and

generation of evidence on episiotomy practice and perineal

trauma. International Journal of Gynecology and Obstetrics.

2010; 111: 13–18.