1
|
Alsuraykh LA, Alnadawi AA, Alharbi A, Alhumaidi KA, Alhabardi N, Almarshud R. Women's Perceptions and Knowledge Toward Episiotomy in Qassim Region, Saudi Arabia. Cureus 2024; 16:e55383. [PMID: 38562338 PMCID: PMC10984130 DOI: 10.7759/cureus.55383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Episiotomy, despite being one of the most common interventions during childbirth, carries significant risks and uncertain benefits. Previous global studies highlight varying awareness levels and practices, with decreasing episiotomy rates attributed to increased knowledge. This study aims to assess women's knowledge to enhance intrapartum decision-making and communication between patients and obstetricians, ultimately improving maternal outcomes in the region. METHODOLOGY The study was a cross-section design. It was conducted through an online survey that was distributed by different social media platforms (Twitter, WhatsApp, and Telegram) from February 2023 to January 2024. It included women living in the Qassim region, Saudi Arabia, who were 15 years old or older. Data was analyzed using the SPSS program (IBM, Chicago, Illinois, USA). RESULTS Among the 402 participants, 62.7% demonstrated awareness of episiotomy, with 94.0% accurately identifying it as a surgical cutting with scissors. About 82.5% acknowledged that not all women require episiotomies, while 48.8% recognized the necessity of anesthesia before the procedure. Understanding the indications for episiotomy varied, with facilitating and accelerating childbirth (64.3%) and dealing with a large baby (62.3%) being the most recognized reasons. Impressively, 90.5% believed that there are methods to avoid perineal cutting, with knowing the correct mechanism for pushing during childbirth (69.4%) and exercise (54.4%) being the most acknowledged preventive measures. Regarding post-cutting care, antibiotics (61.5%) were identified as essential, followed by analgesia (52.8%) and laxatives (48.8%). CONCLUSION The study reveals a notable awareness among participants, with a majority demonstrating a solid understanding of the procedure, its indications, and post-procedure care. It identified specific knowledge gaps, such as the need for anesthesia awareness and divergent beliefs about post-episiotomy care practices.
Collapse
Affiliation(s)
- Lubna A Alsuraykh
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Aseel A Alnadawi
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Aeshah Alharbi
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Kadi A Alhumaidi
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Nadiyah Alhabardi
- Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Raghad Almarshud
- General Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| |
Collapse
|
2
|
Khalaf A, Al Amri N, Al Qadire M. Childbirth-related episiotomy and tear in relation to risk of postpartum depression: a retrospective cohort study on Omani mothers. J Reprod Infant Psychol 2023:1-14. [PMID: 38153261 DOI: 10.1080/02646838.2023.2300082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/23/2023] [Indexed: 12/29/2023]
Abstract
AIMS/BACKGROUND Studies on the association between perineal trauma (episiotomy and tear) and the risk of postpartum depression in Omani mothers are scarce. This study aimed to screen women for the risk of postpartum depression and associated maternal adverse outcomes (episiotomy and tear) in newly delivered Omani mothers. DESIGN/METHODS Mothers were screened for postpartum depression using only the Edinburgh Postnatal Depression Scale (EPDS), with cut-offs of 1-12 indicating low risk and 13-30 indicating high risk. Data on birth outcomes were collected retrospectively from the medical records. Descriptive analyses, group comparisons, and linear regression analyses were conducted. RESULTS Of the 262 participating mothers (total sample, i.e. mothers with and without depression), 19.0% had an episiotomy, 29.0% had tears, and 52.0% had an intact perineum after their childbirth. The total EPDS score was significantly higher among mothers with episiotomy (10.4, SD = 5.4) compared to those with tears (8.1, SD = 4.8) and those with intact perineum (9.4, SD = 4.9) (p-value <0.05). Lower levels of depression (-2.23 points on average) were significantly (p-value <0.05) associated with higher levels of perineum status (coded as 1 = episiotomy, 2 = other). Mothers who had a tear or episiotomy had on average 1.24 points higher EPDS scores compared to mothers with an intact perineum, although not significant (p-value >0.05). CONCLUSIONS Policymakers and clinicians are recommended to consider following up mothers with adverse birth outcomes to outline the risk of developing postpartum depression, at the same time as they routinely screen all mothers for risk of postpartum depression during their postpartum visits.
Collapse
Affiliation(s)
- Atika Khalaf
- The PRO-CARE Group, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
- Fatima College of Health Sciences, Department of Nursing, Ajman, United Arab Emirates
| | - Nawal Al Amri
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
- Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| |
Collapse
|
3
|
Hadımlı A, Eksioglu A, Duman N, Turfan EÇ. Episiotomy Skills Self-Efficacy Scale (ESSES): Development and psychometric properties. NURSE EDUCATION TODAY 2023; 129:105913. [PMID: 37506623 DOI: 10.1016/j.nedt.2023.105913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/03/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Episiotomy is a surgical procedure that increases midwifery students' anxiety levels and reduces their self-efficacy levels. However, there is no valid and reliable tool to assess the student's episiotomy experience-related self-efficacy levels. OBJECTIVES The study was aimed at developing the Episiotomy Skills Self-Efficacy Scale and investigating its psychometric properties. DESIGN In the study, the descriptive, cross-sectional and methodological design was used. SETTING The study was conducted at the midwifery department of a state university in western Turkey. PARTICIPANTS The study sample included 209 midwifery students selected using the convenience sampling method. METHODS A comprehensive literature review and expert panel was conducted on episiotomy skills. Content validity was performed by 10 health professionals. Of them, one was an obstetrician and gynecologist, four were midwives and five were faculty members working in midwifery departments of different universities. The Episiotomy Skills Self-Efficacy Scale was administered to the 3rd and 4th grade students who had taken a course on childbirth. The inclusion criteria were as follows: having received episiotomy training, and having opened and closed an episiotomy on a model in the laboratory. Exploratory and confirmatory factor analysis was performed within the scope of validity. Reliability was evaluated with the Cronbach's alpha method and item-total correlations. RESULTS A two-factor structure which explained 77.96 % of the total variance was obtained by factor analysis. Its "Preparation for and Implementation of Episiotomy" dimension includes 11 items, and "Episiotomy Repair and Control" dimension includes 8 items. Model fit indices were at an acceptable level. The Cronbach's alpha coefficient of the scale was 0.97. CONCLUSIONS The Episiotomy Skills Self-Efficacy Scale has sufficient psychometric validity and reliability. It is short and easily administered.
Collapse
Affiliation(s)
- Aytül Hadımlı
- Ege University Faculty of Health Sciences, Midwifery Department, 35100 Bornova, Izmir, Turkey.
| | - Aysun Eksioglu
- Ege University Faculty of Health Sciences, Midwifery Department, 35100 Bornova, Izmir, Turkey.
| | - Nur Duman
- Ege University Faculty of Health Sciences, Midwifery Department, 35100 Bornova, Izmir, Turkey.
| | - Esin Çeber Turfan
- Ege University Faculty of Health Sciences, Midwifery Department, 35100 Bornova, Izmir, Turkey.
| |
Collapse
|
4
|
Öz T, Güloğlu ZE. Evaluation of education and counseling using social media tools after discharge in women who underwent episiotomy. Health Care Women Int 2023; 45:910-928. [PMID: 37566688 DOI: 10.1080/07399332.2023.2243259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
In this study, it was aimed to evaluate the effects of post-discharge education and counseling using social media tools on wound healing, pain status, and care and practices for women with episiotomy. The study was conducted experimentally with 60 women (30 experimental, 30 control) who had vaginal delivery with episiotomy in a public hospital in Istanbul. Data were collected using a data entry form and evaluations on the REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) scale, VAS (Visual Analogue Scale), and Diagnostic Form for Episiotomy Care and challenges. In our study, training and counseling were given to the experimental group by making video calls via social media on the 3rd, 5th, 7th, and 14th postnatal days (PP), and the results were evaluated without any training to the control group. SPSS program was used for data analysis. There was no difference between the experimental and control groups in terms of demographic and obstetric data. It was determined that the total scores of the experimental group on the REEDA scale on the 7th postnatal day (x¯ =2.167 ± 0.747) were statistically significantly lower than the total scores of the control group on the REEDA scale on 7th postnatal day (x¯ =3.100 ± 0.923) (p = 0.000 > 0.05). It was determined that the total scores of the experimental group on REEDA scale on the 14th postnatal day (x¯ =0.200 ± 0.407) were also statistically significantly lower than the total scores of the control group on REEDA scale on the 14th postnatal day. (x¯ =1.333 ± 0.844) (p = 0.000 > 0.05). The VAS DS scores of the experimental group on 3rd (x¯ =4.733 ± 0.907) and the 5th (x¯ =3.267 ± 0.691) postnatal day were statistically significantly lower than the VAS DS scores of the control group on 3rd (x¯ =5.267 ± 0.944) and 5th (x¯ =3.933 ± 0.944) (p = 0.003 > 0.05) postnatal day. In the light of this information, it was found that scores on REEDA scale were lower and pain experiences were significantly less in the group that received education and counseling with social media tools after discharge in women who underwent episiotomy.
Collapse
Affiliation(s)
- Tuğba Öz
- Department of Nursing, Faculty of Health Sciences, Istanbul Beykent University, Istanbul, Turkey
- Department of Obstetrics and Gynaecology Nursing, Graduate School of Health Sciences, Marmara University, Istanbul, Turkey
| | - Zübeyde Ekşi Güloğlu
- Division of Nursing, Department of Obstetrics and Gynaecology Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| |
Collapse
|
5
|
Faden YA, Fatani AM, Fallatah BM, Rawa TS, Almasri SA, El Amin NO, Rawas SA, Al-Hindi MY. Examining the Association Between Episiotomy and Severe Perineal Tears in a Tertiary Care Center Implementing a Restrictive Episiotomy Policy. Cureus 2022; 14:e31606. [DOI: 10.7759/cureus.31606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 11/19/2022] Open
|
6
|
Bekele H, Tamiru D, Debella A, Getachew A, Yohannes E, Lami M, Negash A, Asfaw H, Ketema I, Eyeberu A, Habte S, Eshetu B, Getachew T, Mesfin S, Birhanu B, Heluf H, Kibret H, Negash B, Alemu A, Dessie Y, Balis B. Magnitude of episiotomy practice and associated factors among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Front Glob Womens Health 2022; 3:911449. [PMID: 36312869 PMCID: PMC9608782 DOI: 10.3389/fgwh.2022.911449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Episiotomy is an intentional surgical incision made on the perineum with the aim of enlarging the introits during the second stage of labor or just before delivery of the baby. It sometimes also interferes with the mother's comfort during the postpartum period and has associated complications especially when it is done without indication. However, there is limited information regarding episiotomy practice in the study area. OBJECTIVE This study aimed to determine the magnitude of episiotomy practice and associated factors among women who gave birth at the Hiwot Fana Specialized University Hospital, Eastern Ethiopia, 2021. METHODS A facility-based cross-sectional study was conducted among 408 systematically selected mothers who gave birth at the Hiwot Fana Specialized University Hospital, from 1 January to 30 December 2021. Datas were collected from delivery medical records using a pretested checklist. The extracted data were checked, coded, and entered into the Epi-data version 3.1 and exported to the STATA version 16 software for analysis. Binary logistic regression was fitted to identify factors associated with episiotomy practice. P-values < 0.05 were considered to declare the presence of statistical significance. RESULTS The overall prevalence of episiotomy practice was found to be 43.4 % (95% CI: 38.7, 48.9), and mediolateral was the most commonly practiced episiotomy type (41.4%). Parity [AOR: 6.2; 95% CI (3.8-17.6)], 1st min Apgar score [AOR: 1.6; 95% CI (1.04-2.67)], presence of maternal medical disease [AOR: 3.3; 95% CI (1.09-6.9)], and induced labor [AOR: 1.6; 95%CI (1.12, 4.13)] were significantly associated with the episiotomy practice. CONCLUSION The prevalence of episiotomy practice in the study area was high. Parity, presence of maternal medical disease, induction of labor, and 1st min APGAR score were significant factors associated with episiotomy practice. Considering the presence of appropriate indications or preventing unjustifiable indications, can help to reduce the current high practice rates.
Collapse
Affiliation(s)
- Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia,*Correspondence: Habtamu Bekele
| | - Dawit Tamiru
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia,Dawit Tamiru
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemeshet Getachew
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ephrem Yohannes
- School of Nursing and Midwifery, College of Health and Medical Sciences, Ambo University, Ambo, Ethiopia
| | - Magarsa Lami
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Indeshaw Ketema
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sisay Habte
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bajrond Eshetu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bekelu Birhanu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Helina Heluf
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haregeweyn Kibret
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
7
|
Woldegeorgis BZ, Obsa MS, Tolu LB, Bogino EA, Boda TI, Alemu HB. Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:905174. [PMID: 35865171 PMCID: PMC9295659 DOI: 10.3389/fmed.2022.905174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Episiotomy, a surgical procedure that enlarges the vaginal opening during childbirth, was common practice until the early 2000s. Other sources, including the World Health Organization (WHO), advocate for the selective use of episiotomy. Episiotomy rates, on the other hand, have remained high in developing countries, while declining in developed countries. As a result, the current study sought to determine the overall prevalence of episiotomy in Africa as well as the risk factors associated with its practice. Methods Articles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 14 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. A random-effects meta-analysis model was used to determine the pooled prevalence of episiotomy. A heterogeneity test was conducted using I-Squared (I2) statistics. Egger's test and funnel plots were conducted to detect publication bias. Subgroup analysis was also conducted. Association was expressed through a pooled odds ratio (OR) with a 95% Confidence Interval (CI). Result A total of 21 studies with 40,831 participants were included in the systematic review and meta-analysis. The pooled prevalence of episiotomy practice was 41.7% [95% CI (36.0–47.4), I2 = 99.3%, P < 0.001). Primiparity [OR: 6.796 (95% CI (4.862–9.498)), P < 0.001, I2: 95.1%], medical doctors- assisted delivery [OR: 3.675 (95% CI (2.034–6.640)), P < 0.001, I2: 72.6%], prolonged second stage of labor [OR: 5.539 (95% CI (4.252–7.199)), P < 0.001, I2: 0.0%], using oxytocin [OR: 4.207 (95% CI (3.100–5.709)), P < 0.001, I2: 0.0%], instrument -assisted vaginal delivery [OR: 5.578 (95% CI (4.285–7.260)), P < 0.001, I2: 65.1%], and macrosomia [OR: 5.32 (95% CI (2.738–10.339)), P < 0.001, I2: 95.1%] were factors associated with episiotomy practice. Conclusion In this review, the prevalence of episiotomy among African parturients was high. A selective episiotomy practice should be implemented to reduce the high episiotomy rates. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021293382, identifier: CRD42021293382.
Collapse
Affiliation(s)
- Beshada Zerfu Woldegeorgis
- Department of Internal Medicine, Wolaita Sodo University, Sodo, Ethiopia
- *Correspondence: Beshada Zerfu Woldegeorgis
| | | | - Lemi Belay Tolu
- Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Efa Ambaw Bogino
- Dermatovenereology Department, Wolaita Sodo University, Sodo, Ethiopia
| | | | | |
Collapse
|
8
|
Deyaso ZF, Chekole TT, Bedada RG, Molla W, Uddo EB, Mamo TT. Prevalence of episiotomy practice and factors associated with it in Ethiopia, systematic review and meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221091659. [PMID: 35435068 PMCID: PMC9019356 DOI: 10.1177/17455057221091659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
An episiotomy is one of the most commonly performed obstetrics surgeries indicated in emergencies during the second stage of labor like fetal distress, dystocia, and tight perineum. As a result, this systematic review and meta-analysis aimed to assess the prevalence of episiotomy practice and associated factors in Ethiopia. Ten cross-sectional studies with a total population of 3718 were included in this study. The search was done using online databases like PubMed, HINARI, Web of Science, other gray, and online repositories of Universities. All the included papers were extracted and appraised using the standard extraction sheet format of JOANNA Briggs Institute. The Cochran Q-test and I2 statistics test were used to test the heterogeneity of studies. To detect the publication bias of the included studies, a funnel plot and Egger's test were used. The pooled prevalence of episiotomy practice and the odds ratio with a 95% confidence interval were presented using forest plots. The overall pooled prevalence of episiotomy practice was 45.11% (95% CI; 37.04-53.18; I2 = 96.3%). Prolonged second stage of labor (OR: 4.79, 95% CI: 3.03, 7.57), face presentation (OR: 4.26, 95% CI: 1.21, 15.07), birth weight > 4000 g (OR: 6.71, 95% CI: 3.14-14.33), instrumental delivery (OR: 4.26, 95% CI 2.95, 6.14), and primiparity (OR: 3.70, 95% CI: 1.90, 7.2) were factors associated with episiotomy practice. The overall prevalence of episiotomy practice was higher in Ethiopia compared to studies conducted in other countries. The prolonged second stage of labor, face presentation, birth weight > 4000 g, instrumental delivery, and primiparity of women were the factors associated with episiotomy practice. Therefore, efforts should be made to prevent routine episiotomy practice through creating awareness, adjusting national guidelines, affecting the World Health Organization episiotomy policy, and monitoring the activities of the health care facilities in executing the protocols.
Collapse
Affiliation(s)
- Zerihun Figa Deyaso
- Department of Midwifery, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
- Zerihun Figa Deyaso, Department of Midwifery, College of Health and Medical Science, Dilla University, Dilla, 419, Ethiopia.
| | - Tesfaye Temesgen Chekole
- Department of Midwifery, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Rediet Gido Bedada
- Department of Midwifery, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Wondwosen Molla
- Department of Midwifery, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Etaferahu Bekele Uddo
- Department of Emergency Critical Nursing, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Tizalegn Tesfaye Mamo
- Department of Epidemiology, College of Health and Medical Science, School of Public Health, Dilla University, Dilla, Ethiopia
| |
Collapse
|
9
|
Kim KW, Lee S. Childbirth outcomes and perineal damage in women with natural childbirth : a review of medical records in a natural birth center in Korea. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2021; 27:379-387. [PMID: 36311447 PMCID: PMC9328644 DOI: 10.4069/kjwhn.2021.08.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
|
10
|
Safari K, McKenna L, Davis J. Midwifery in Middle Eastern and North African countries: A scoping review. Women Birth 2021; 34:503-513. [PMID: 33199188 DOI: 10.1016/j.wombi.2020.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/14/2020] [Accepted: 11/07/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND While midwives are positioned as critical providers for improving sexual, reproductive, maternal and newborn health outcomes in the Middle East and North African (MENA) countries, the standards of midwifery have not been explored systematically in this region. AIM The purpose of this scoping review was to provide an overview of existing literature on midwifery practice, education, and regulation in MENA countries in the context of ICM standards. METHODS A search was conducted inclusive of English and Persian written studies published between 2000 and 2019 in CINAHL plus; Ovid MEDLINE; PubMed; Scopus; and grey literature. Title and abstract and full-text review were performed in Covidence, and data extraction and synthesis performed using NVivo 12. RESULTS The initial search identified 7,994 articles. Overall, 139 studies were included in the review. Although, the primary concept of most included studies was "midwifery practice", "midwifery regulation" was addressed in limited way. Approximately 90% were from Middle Eastern countries. Forty-two per cent of studies used cross-sectional designs, and most originated from Iran, Jordan, and Palestine. Diversity was found in midwifery education, practice and regulation across the MENA countries. Midwives from different nations had uneven levels of proficiency, scope of practice, and education. Midwifery curricula were aligned with ICM competencies in some countries. Most countries had midwifery associations and were members of ICM. Some countries had regulations recognising midwifery as an autonomous profession. CONCLUSION Midwifery practice, education and regulation in MENA countries were not always comparable with ICM standards, although some progress was evident.
Collapse
Affiliation(s)
- Kolsoom Safari
- School of Nursing and Midwifery, La Trobe University, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Australia
| | - Jenny Davis
- School of Nursing and Midwifery, La Trobe University, Australia
| |
Collapse
|
11
|
Tex-Jack D, Eleke C. Perspectives of skilled birth attendants and pregnant women regarding episiotomy: a quantitative approach. Afr Health Sci 2021; 21:1355-1361. [PMID: 35222601 PMCID: PMC8843249 DOI: 10.4314/ahs.v21i3.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The World Health Organization recommended less than 10% episiotomy rate for Skilled Birth Attendants (SBAs) and hospitals in 1996. More than two decades afterwards, some health facilities are still grappling with meeting the set target. Objectives This study assessed the perspectives of SBAs and pregnant women regarding episiotomy in a Nigerian university teaching hospital. Methods A cross-sectional design was employed. Census sampling was used to select 19 SBAS and 973 vaginal birth records from 2019, while consecutive sampling technique was used to enrol 134 consenting pregnant women obtaining antenatal services in the facility. Data was collected using a three part instrument involving a data extraction sheet, episiotomy practice questionnaire for SBAs, and feelings about episiotomy questionnaire for pregnant women. Assembled data were summarised with descriptive statistics. Results The episiotomy rate was 345(35.5%). About 266 (77.1%) of first time mothers (primips) and 79(22.9%) of nonfirst time mothers (multips) received episiotomy. Ten (52.6%) of the SBAs were unsure of any evidence supporting routine episiotomy. All the 19(100%) SBAs reported that there was no existing facility-based policy regarding routine episiotomy. Seventy five (56%) of the pregnant women reported feeling generally bad about episiotomy. One hundred and one (82.3%) of them hinted that they will not feel satisfied if they were given episiotomy with the reason that it ensures quick vaginal birth. Conclusion The rate of episiotomy was higher than global recommended standards and primips are disproportionately affected. If organised by professional societies, more scientific conferences on limiting episiotomy might remedy this situation.
Collapse
Affiliation(s)
- Dokuba Tex-Jack
- University of Port Harcourt, African Centre of Excellence, Centre for Public Health and Toxicological Research
| | | |
Collapse
|
12
|
Effectiveness of Olea Herbal Ointment on Episiotomy Wound Healing Among Primiparous Women: A Randomized Clinical Trial. Jundishapur J Nat Pharm Prod 2021. [DOI: 10.5812/jjnpp.104570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Episiotomy is a surgical incision in the perineal region to increase the vaginal diameter during delivery. Since the perineal region is not well visible to the mothers and there is a possibility of infection for the episiotomy wound by vaginal and rectal bacteria, such a cut is associated with infection and delay in wound healing. Objectives: This study aimed to detect the effect of Olea ointment on episiotomy wound healing among primiparous women. Methods: This randomized controlled clinical trial included 73 women referring to the Al-Zahra Education, Research, and Remedial Center in Rasht, Iran, during 2017 - 18. Women were randomly assigned into two groups: Intervention group (n = 39) and control group (n = 34). Episiotomy wound healing was assessed using the REEDA scale prior to the intervention, 2 and 24 hours following the first intervention, and 5 and 10 days after delivery. Statistical analysis was performed using Fisher’s exact test, Mann-Whitney U test, independent t-test, repeated-measure test, Friedman test, and chi-square. Results: The mean baseline scores of REEDA was 2.72 ± 0.46 in the Olea ointment group and 2.71 ± 0.46 in the control group; however, there was no statistically significant difference between the two groups. On the other hand, the episiotomy healing scores in the Olea ointment group were significantly lower than those of the control group at four intervals in the follow-up assessments: -0.34 (95% CI: -0.56 to -0.12) two hours after intervention, -0.63(95% CI: -0.89 to -0.37) 24 hours after intervention, -0.30 (95% CI: -0.48 to -0.12) on Day 5 postpartum, and -0.29 (95% CI: -0.46 to -0.13) on Day 10 postpartum. Conclusions: The present findings suggested that the Olea ointment facilitated wound healing of episiotomy; however, further studies are suggested to support these data.
Collapse
|
13
|
YILAR ERKEK Z, ÖZTÜRK ALTINAYAK S. The Effect of Simulation Teaching Technique on the Improvement of Episiotomy Performance Skills and State Anxiety of Midwifery Students in Turkey: RCT. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
14
|
Masuda C, Ferolin SK, Masuda K, Smith C, Matsui M. Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study. BMC Pregnancy Childbirth 2020; 20:78. [PMID: 32024504 PMCID: PMC7003416 DOI: 10.1186/s12884-020-2778-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/29/2020] [Indexed: 12/03/2022] Open
Abstract
Background Evidenced-based practice is a key component of quality care. However, studies in the Philippines have identified gaps between evidence and actual maternity practices. This study aims to describe the practice of evidence-based intrapartum care and its associated factors, as well as exploring the perceptions of healthcare providers in a tertiary hospital in the Philippines. Methods A mixed-methods study was conducted, which consisted of direct observation of intrapartum practices during the second and third stages, as well as semi-structured interviews and focus group discussions with care providers to determine their perceptions and reasoning behind decisions to perform episiotomy or fundal pressure. Univariate and multivariate logistic regression were used to analyse the relationship between observed practices and maternal, neonatal, and environmental factors. Qualitative data were parsed and categorised to identify themes related to the decision-making process. Results A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices were also observed, such as intramuscular or intravenous oxytocin use in the second stage (14%) and lack of foetal heart rate monitoring (57%). Of primiparae, 92% received episiotomy and 31% of all deliveries received fundal pressure. Factors associated with the implementation of episiotomy included primipara (adjusted Odds Ratio [aOR] 62.3), duration of the second stage of more than 30 min (aOR 4.6), and assisted vaginal delivery (aOR 15.0). Factors associated with fundal pressure were primipara (aOR 3.0), augmentation with oxytocin (aOR 3.3), and assisted delivery (aOR 4.8). Healthcare providers believe that these practices can prevent laceration. The rate of obstetric anal sphincter injuries (OASIS) was 17%. Associated with OASIS were assisted delivery (aOR 6.0), baby weights of more than 3.5 kg (aOR 7.8), episiotomy (aOR 26.4), and fundal pressure (aOR 6.2). Conclusions Our study found that potentially harmful practices are still conducted that contribute to the occurrence of OASIS. The perception of these practices is divergent with current evidence, and empirical knowledge has more influence. To improve practices the scientific evidence and its underlying basis should be understood among providers.
Collapse
Affiliation(s)
- Chisato Masuda
- Department of Global Health, Nagasaki University School of Tropical Medicine and Global Health, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Shirley Kristine Ferolin
- Department of Obstetrics and Gynaecology, Southern Philippines Medical Centre, JP Laurel Avenue, Bajada, Davao City, 8000, The Philippines
| | - Ken Masuda
- Department of Global Health, Nagasaki University School of Tropical Medicine and Global Health, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Chris Smith
- Department of Global Health, Nagasaki University School of Tropical Medicine and Global Health, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E7HT, UK
| | - Mitsuaki Matsui
- Department of Global Health, Nagasaki University School of Tropical Medicine and Global Health, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.
| |
Collapse
|
15
|
Zimmo KM, Laine K, Fosse E, Zimmo M, Ali-Masri H, Böttcher B, Zucknick M, Vikanes Å, Hassan S. Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study. Int Urogynecol J 2019; 30:1343-1350. [PMID: 30008080 PMCID: PMC6647226 DOI: 10.1007/s00192-018-3711-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/20/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS In Palestine, episiotomy is frequently used among primiparous women.This study assesses the effect of training birth attendants in applying bimanual perineal support during delivery by either animated instruction on tablets or hands-on training on episiotomy rates among primiparous women. METHODS An interventional cohort study was performed from 15 October 2015 to 31 January 2017, including all primiparous women with singletons and noninstrumental vaginal deliveries at six Palestinian hospitals. Intervention 1 (animated instructions on tablets) was conducted in Hospitals 1, 2, 3, and 4. Intervention 2 (bedside hands-on training) was applied in Hospitals 1 and 2 only. Hospitals 5 and 6 did not receive interventions. Differences in episiotomy rates in intervention and nonintervention hospitals were assessed before and after the interventions and presented as p values using chi-square test, and odds ratios (OR) with 95% confidence intervals (CI). Differences in the demographic and obstetric characteristics were presented as p values using the Kruskal-Wallis test. RESULTS Of 46,709 women, 12,841 were included. The overall episiotomy rate in the intervention hospitals did not change significantly after intervention 1, from 63.1 to 62.1% (OR = 0.96, 95% CI 0.84-1.08), but did so after intervention 2, from 61.1 to 38.1% (OR = 0.39, 95% CI 0.33-0.47). Rates after Intervention 2 changed from 65.0 to 47.3% (OR = 0.52, 95% CI 0.40-0.67) in Hospital 1 and from 39.4 to 25.1% (OR = 0.49, 95% CI 0.35-0.68) in Hospital 2. CONCLUSIONS Hands-on training of bimanual perineal support during delivery of primiparous women was significantly more effective in reducing episiotomy rates than animated instruction videos alone.
Collapse
Affiliation(s)
- Kaled Mikki Zimmo
- Department of Obstetrics, Al Aqsa Hospital, Gaza, Palestine.
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway.
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Katariina Laine
- Department of Health Management and Health Economics, Institute for Health and Society, University of Oslo, Oslo, Norway
- Department of Obstetrics, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Erik Fosse
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mohammed Zimmo
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics, Al Shifa Hospital, Gaza, Palestine
| | - Hadil Ali-Masri
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics, Palestine Medical Complex, Ramallah, Palestine
| | - Bettina Böttcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Manuela Zucknick
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Åse Vikanes
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway
| | - Sahar Hassan
- Departement of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| |
Collapse
|
16
|
Khresheh R, Barclay L. Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives in Jordan. Women Birth 2019; 33:e176-e181. [PMID: 30910398 DOI: 10.1016/j.wombi.2019.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/08/2019] [Accepted: 03/10/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Episiotomy is still performed routinely by clinicians in many countries. The aim of this study was to determine the knowledge of, attitudes towards and experience of episiotomy practice among clinicians working in public hospitals in Jordan. METHODS A cross-sectional study, using a self-administered survey questionnaire, was conducted among midwives and obstetricians in three public hospitals in Jordan. RESULTS 112 (87.5%) clinicians responded to the questionnaire. Low knowledge level of evidence about overuse and risk of episiotomy was identified among participants with a significant difference among obstetricians and midwives (P<0.05). Results revealed that both obstetricians and midwives have limited access to evidence which is not emphasised in their learning, practice, or hospital policy. The majority of obstetricians (80%) and midwives (79%) thought an episiotomy rate of 81% is about right. The most common reason for performing episiotomy identified by both obstetricians (83.1%) and midwives (75.5%) was to reduce the risk of 3rd and 4th degree perineal laceration. The most common obstacle to reducing episiotomy rate reported by obstetricians (78.0%) was lack of training on preventing perineal tears, while the most common obstacles reported by midwives were insufficient time to wait for the perineum to stretch (56.6%) and difficulty changing the conventional practices in the labour ward (52.8%). CONCLUSION This study identifies that obstetricians and midwives in Jordan rely on non evidence-based beliefs to guide their practice on performing an episiotomy. Training, continuing education, and developing evidence based clinical policies and guidelines for surgical procedures, such as in an episiotomy, are needed.
Collapse
Affiliation(s)
| | - Lesley Barclay
- School of Medicine, University Centre for Rural Health, The University of Sydney, NSW Australia.
| |
Collapse
|
17
|
Zhang M, Wang M, Zhao X, Ren J, Xiang J, Luo B, Yao J. Risk factors for episiotomy during vaginal childbirth: A retrospective cohort study in Western China. J Evid Based Med 2018; 11:233-241. [PMID: 30160052 DOI: 10.1111/jebm.12316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/02/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To assess the incidence rates and risk factors for episiotomy during vaginal childbirth in a Western China context. METHODS A retrospective hospital-based cohort study was conducted using computerized data of 3721 singleton vaginal deliveries after 28 weeks of gestation. Women who underwent episiotomy were compared with those who did not. RESULTS The overall prevalence of episiotomy was 44.0% (1636/3721); 52.9% (1458/2756) among primiparas and 18.4% (178/965) among multiparas (P < 0.001). Adjusted risk factors significantly associated with episiotomy included primiparity, prolonged second stage of labor, and labor-management personnel. Risk factors specific to primiparas were increasing maternal age (per year) (OR = 1.04, 95% CI 1.01 to 1.07, P = 0.035), increasing biparietal diameter (per centimeter) (OR = 1.40, 95% CI 1.06 to 1.84, P = 0.017), first stage of labor beyond 10-hour (OR = 1.36, 95% CI 1.10 to 1.68, P = 0.005), and birth weight (per 100 g) (OR = 1.06, 95% CI 1.03 to 1.09, P < 0.001). Birth weight resulted in an adjusted risk increase of 6.1% among primiparas for every 100 additional grams of birth weight. For the analysis stratified by labor-management personnel, moderately experienced midwifery was a risk factor of episiotomy (OR = 1.76, 95% CI 1.21 to 2.56, P = 0.003); midwives with bachelor's degree (OR = 1.47, 95% CI 1.15 to 1.88, P = 0.002), and obstetricians with doctor's degree (OR = 2.00, 95% CI 1.18 to 3.39, P = 0.010) were most likely to perform episiotomy. CONCLUSION Episiotomy is still commonly performed in Western China. A survey of maternity care professionals' knowledge of and attitudes towards episiotomy is urgently required to explore the complex reasons for conducting episiotomy.
Collapse
Affiliation(s)
- Mengqin Zhang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| | - Min Wang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| | - Xiufang Zhao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| | - Jianhua Ren
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| | - Jie Xiang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| | - Biru Luo
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| | - Jianrong Yao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P. R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, P. R. China
| |
Collapse
|
18
|
Clesse C, Lighezzolo-Alnot J, De Lavergne S, Hamlin S, Scheffler M. Statistical trends of episiotomy around the world: Comparative systematic review of changing practices. Health Care Women Int 2018; 39:644-662. [PMID: 29509098 DOI: 10.1080/07399332.2018.1445253] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The authors' purpose for this article is to identify, review and interpret all publications about the episiotomy rates worldwide. Based on the criteria from the PRISMA guidelines, twenty databases were scrutinized. All studies which include national statistics related to episiotomy were selected, as well as studies presenting estimated data. Sixty-one papers were selected with publication dates between 1995 and 2016. A static and dynamic analysis of all the results was carried out. The assumption for the decline in the number of episiotomies is discussed and confirmed, recalling that nowadays high rates of episiotomy remain in less industrialized countries and East Asia. Finally, our analysis aims to investigate the potential determinants which influence apparent statistical disparities.
Collapse
Affiliation(s)
- Christophe Clesse
- a Interpsy Laboratory (EA4432) , Université de Lorraine , Nancy , France.,b Hospital Centre of Jury-les-Metz - Route d'Ars Laquenexy , Jury , France.,c Polyclinic Majorelle , Nancy , France
| | | | | | | | - Michèle Scheffler
- c Polyclinic Majorelle , Nancy , France.,d Cabinet de Gynécologie Médicale et Obstétrique , Nancy , France
| |
Collapse
|
19
|
Rekoronirina E, Rahariniaina J, Rasoaherinomenjanahary F. [Factors associated with first pregnancy in women who gave birth in a maternity hospital in Antananarivo: a retrospective cohort study]. Pan Afr Med J 2018; 29:32. [PMID: 29875914 PMCID: PMC5987107 DOI: 10.11604/pamj.2018.29.32.13169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 12/12/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction Il y a très peu de littératures africaines et Malgaches concernant les détails sur les facteurs de risques qu'encourent les primigestes en général. Le but de notre étude est de déterminer les facteurs de risques potentiels associés à une première grossesse. Méthodes Une étude cohorte rétrospective a été menée auprès des femmes primigestes et multigestes de l'hôpital Pavillon sainte Fleur entre Octobre 2014 et Décembre 2016. Les risques relatifs étaient ajustés après contrôle avec les caractéristiques sociodémographiques. Résultats Les primigestes étaient beaucoup plus exposées à un travail prolongé de plus de 12h (RRa = 2,28; IC 95% 1,74-3,00), à une césarienne en urgence (RRa = 1,47; IC 95% 1,35-1,60) et à une épisiotomie (RRa = 2,98; IC 95% 2,61-3,40). Leurs enfants étaient plus susceptibles de présenter des signes de souffrance fœtale avec anomalie du rythme cardiaque fœtale au cours de la phase de travail (RRa = 1,96; IC 95% 1,45-2,65) et un risque accru d'être admis dans une unité de soins intensifs après l'accouchement (RRa = 2,08; IC 95% 1,25-3,45). Conclusion Les complications survenues pendant le travail auraient exposé les primigestes à d'autres risques en cascades sur l'issue de leurs accouchements et sur la santé de leurs enfants. La prise en charge des primigestes nécessiterait, de la part des personnels médicaux, une attention particulière sur la durée de la phase de travail.
Collapse
Affiliation(s)
- Eddie Rekoronirina
- Faculté de Médecine, Université d'Antananarivo, Antananarivo 101, Madagascar.,Pavillon Sainte Fleur, Hôpital CHU/JRA Ampefiloha, Antananarivo 101, Madagascar
| | - Justin Rahariniaina
- PSI Madagascar Immeuble Fiaro Escalier D 2 étage Ampefiloha, Antananarivo 101, Madagascar, Population Services International, 1120 19 St NW Suite 600, Washington, DC 20036, USA
| | - Fanjandrainy Rasoaherinomenjanahary
- Faculté de Médecine, Université d'Antananarivo, Antananarivo 101, Madagascar.,Service de Chirurgie viscérale B - CHU-JRA Antananarivo, Madagascar
| |
Collapse
|
20
|
Zaidan A, Hindi M, Bishara A, Alolayan S, Abduljabbar H. The Awareness Regarding the Episiotomy Procedure Among Women in Saudi Arabia. Mater Sociomed 2018; 30:193-197. [PMID: 30515058 PMCID: PMC6195407 DOI: 10.5455/msm.2018.30.193-197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: Episiotomy is an intended incision made through the perineal body to enlarge the vaginal orifice during the second stage of labor to ease the parturition. A cross sectional study in Jeddah, Saudi Arabia, showed that 35% of the females in 2012 had an episiotomy, this slightly increased in 2015 to (36.4%). Given the increase rates of episiotomy and the significance of patients’ awareness, there were very limited data on the awareness of episiotomy among women. Aim: Aim of this study is to estimate the extent of the awareness regarding the episiotomy procedure among women in Saudi Arabia. Material and methods: Participants aged 15 and above filled a questionnaire distributed online to different regions of Saudi Arabia. Descriptive statistics were used. Results: a total of 626 women participated in this study with a mean age 34.7 years. The majority (63.6%) of women reported being informed about the procedure. Still, only (40%) of them were able to describe the procedure correctly. Only age, parity and history of previous episiotomy were predictors for episiotomy awareness. Women aged 35 or less were more aware of episiotomy than those aged more than 35 with a p-value (<0.001). However, the multigravida were more aware of episiotomy than primigravida with a p-value (< 0.001). Conclusion: The awareness of episiotomy is still not accomplish in Saudi Arabia, which poses the need for further modalities to educate women and increase their awareness regarding selective episiotomy rather than the old method of routine episiotomy.
Collapse
Affiliation(s)
- Asma Zaidan
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Muhab Hindi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Bishara
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Samar Alolayan
- Obstetrics and Gynecology Department, Faculty of Medicine, Jeddah University, Jeddah, Kingdom of Saudi Arabia
| | - Hassan Abduljabbar
- Obstetrics and Gynecology Department, Faculty of Medicine, Jeddah University, Jeddah, Kingdom of Saudi Arabia
| |
Collapse
|
21
|
Kartal B, Kızılırmak A, Calpbinici P, Demir G. Retrospective analysis of episiotomy prevalence. J Turk Ger Gynecol Assoc 2017; 18:190-194. [PMID: 29278232 PMCID: PMC5776158 DOI: 10.4274/jtgga.2016.0238] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 08/01/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE This study was performed to determine the rate of episiotomy. MATERIAL AND METHODS This retrospective was conducted in 3 state hospitals located in 3 cities in the Central Anatolia region of Turkey. Ethics committee approval was received for this study. Also, institutional permissions from the institutions where the study was conducted were obtained before the study. The sample of the study consisted of 8587 women. The data of the study were collected by analyzing birth records in archive records. RESULTS The average age of the women was 26.16±5.9 years, the average number of deliveries was 2.19±1.2, and 52.0% of the women who gave birth via vaginal delivery underwent episiotomy. The rate of episiotomy was found to be 93.3% in primipara women and 30.2% in multipara women. It was determined that neonatal weight did not affect the episiotomy rate, and that neonatal height was higher in deliveries with episiotomy and suture. Also, it was determined that as the age and parity of the women decreased, the rate of episiotomy increased. CONCLUSION The rate of episiotomy was observed to be high, especially in primipara women.
Collapse
Affiliation(s)
- Bahtışen Kartal
- Department of Nursing, Gaziosmanpaşa University Faculty of Health Sciences, Tokat, Turkey
| | - Aynur Kızılırmak
- Department of Nursing, Nevşehir Hacı Bektaş Veli University Semra and Vefa Küçük School of Health, Nevşehir, Turkey
| | - Pelin Calpbinici
- Nevşehir Hacı Bektaş Veli University Semra and Vefa Küçük School of Health, Nevşehir, Turkey
| | - Gökçe Demir
- Department of Nursing, Ahi Evran University School of Health, Kırşehir, Turkey
| |
Collapse
|