Anne M Weber1, Leslie Meyn. 1. Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh, Pennsylvania, USA.
Abstract
OBJECTIVE: To describe episiotomy usage at vaginal delivery in the United States from 1979-1997. METHODS: We used the National Hospital Discharge Survey, a federal database of a national sample of inpatient hospitals. Data from 1979 to 1997 were analyzed using International Classification of Diseases, Ninth Revision, Clinical Modification codes for diagnoses and procedures. Rates per 1000 women were calculated using the 1990 census population for women aged 15-44 years. We calculated the number of episiotomies per 100 vaginal deliveries. Rates and percentages were compared using the score test for linear trend. RESULTS: The number of episiotomies ranged from a high of 2,015,000 in 1981 to a low of 1,128,000 in 1997. The age-adjusted annual rate for episiotomy with vaginal deliveries varied from 32.7 in 1979 to 18.7 in 1997 per 1000 women aged 15-44 years. The percentage of episiotomy with vaginal deliveries ranged from 65.3% in 1979 to 38.6% in 1997 (P <.001). Episiotomy with operative deliveries decreased over time (87.0% to 70.8%, P <.001), as did episiotomy with spontaneous deliveries (60.1% to 32.8%, P <.001). Women undergoing episiotomy were slightly younger (mean +/- standard deviation, 25.7 +/- 5.5 years) than women without episiotomy (26.2 +/- 5.7 years, P <.001). Black women (39%) were less likely to receive episiotomy than white women (60%, P <.001). More women with private insurance (62%) had episiotomy performed than women with government insurance (43%, P <.001). CONCLUSION: Although episiotomy use has decreased over time, the most recent rate of 39 per 100 vaginal deliveries remains higher than evidence-based recommendations for optimal patient care.
OBJECTIVE: To describe episiotomy usage at vaginal delivery in the United States from 1979-1997. METHODS: We used the National Hospital Discharge Survey, a federal database of a national sample of inpatient hospitals. Data from 1979 to 1997 were analyzed using International Classification of Diseases, Ninth Revision, Clinical Modification codes for diagnoses and procedures. Rates per 1000 women were calculated using the 1990 census population for women aged 15-44 years. We calculated the number of episiotomies per 100 vaginal deliveries. Rates and percentages were compared using the score test for linear trend. RESULTS: The number of episiotomies ranged from a high of 2,015,000 in 1981 to a low of 1,128,000 in 1997. The age-adjusted annual rate for episiotomy with vaginal deliveries varied from 32.7 in 1979 to 18.7 in 1997 per 1000 women aged 15-44 years. The percentage of episiotomy with vaginal deliveries ranged from 65.3% in 1979 to 38.6% in 1997 (P <.001). Episiotomy with operative deliveries decreased over time (87.0% to 70.8%, P <.001), as did episiotomy with spontaneous deliveries (60.1% to 32.8%, P <.001). Women undergoing episiotomy were slightly younger (mean +/- standard deviation, 25.7 +/- 5.5 years) than women without episiotomy (26.2 +/- 5.7 years, P <.001). Black women (39%) were less likely to receive episiotomy than white women (60%, P <.001). More women with private insurance (62%) had episiotomy performed than women with government insurance (43%, P <.001). CONCLUSION: Although episiotomy use has decreased over time, the most recent rate of 39 per 100 vaginal deliveries remains higher than evidence-based recommendations for optimal patient care.
Authors: Kathy L Kyser; Xin Lu; Donna A Santillan; Mark K Santillan; Stephen K Hunter; Alison G Cahill; Peter Cram Journal: Am J Obstet Gynecol Date: 2012-05-16 Impact factor: 8.661
Authors: Steven M Minaglia; Begüm Ozel; Nicole M Gatto; Lisa Korst; Daniel R Mishell; David A Miller Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2007-03-28
Authors: Kathy L Kyser; Xin Lu; Donna Santillan; Mark Santillan; Aaron B Caughey; Mark C Wilson; Peter Cram Journal: Acad Med Date: 2014-01 Impact factor: 6.893
Authors: Anna Seijmonsbergen-Schermers; Thomas van den Akker; Katrien Beeckman; Annick Bogaerts; Monalisa Barros; Patricia Janssen; Lorena Binfa; Eva Rydahl; Lucy Frith; Mechthild M Gross; Berglind Hálfdánsdóttir; Deirdre Daly; Jean Calleja-Agius; Patricia Gillen; Anne Britt Vika Nilsen; Eugene Declercq; Ank de Jonge Journal: BMJ Open Date: 2018-01-10 Impact factor: 2.692