OBJECTIVE: To examine the episiotomy rate for women delivering in a regional hospital versus the rate in rural hospitals. DESIGN: Retrospective review of low-risk delivery charts for a 12-month period (2006 to 2007). SETTING: One regional and 3 rural hospitals in southern Alberta. PARTICIPANTS: Charts were reviewed for a random sample of 10% of the women with low-risk deliveries at the regional hospital, and all such women at the participating rural hospitals. Eligible women were nulliparous or multiparous, were at 37 or more weeks' gestation, and delivered live newborns vaginally, including spontaneous and assisted vaginal deliveries. Low-risk deliveries were defined by the absence of high-risk maternal, prenatal, and perinatal features. MAIN OUTCOME MEASURES: Details of the delivery, including use of episiotomy. RESULTS: Charts were reviewed for 115 women who delivered in the regional hospital and for 140 women from the rural hospitals. Maternal and infant characteristics did not differ between settings (mean age 26 years, median parity 1, mean birth weight 3433 g [regional] and 3462 g [rural], and mean head circumference 35 cm). Episiotomies were performed in 13% of regional and 4% of rural deliveries (P = .01). Perineal tears occurred in 65% of regional (3 with third- to fourth-degree tears) and 57% of rural (2 with third- to fourth-degree tears) deliveries (P = .20). Deliveries were carried out by 12 FPs and 6 obstetricians in the regional centre, and by 19 FPs in the rural hospitals. CONCLUSION: In our study, both rural and regional practitioners in southern Alberta demonstrated a "restrictive" use of episiotomy, in keeping with current evidence-based guidelines. Further prospective research is needed to examine how physician, maternal, and pregnancy characteristics affect episiotomy and perineal tear rates.
OBJECTIVE: To examine the episiotomy rate for women delivering in a regional hospital versus the rate in rural hospitals. DESIGN: Retrospective review of low-risk delivery charts for a 12-month period (2006 to 2007). SETTING: One regional and 3 rural hospitals in southern Alberta. PARTICIPANTS: Charts were reviewed for a random sample of 10% of the women with low-risk deliveries at the regional hospital, and all such women at the participating rural hospitals. Eligible women were nulliparous or multiparous, were at 37 or more weeks' gestation, and delivered live newborns vaginally, including spontaneous and assisted vaginal deliveries. Low-risk deliveries were defined by the absence of high-risk maternal, prenatal, and perinatal features. MAIN OUTCOME MEASURES: Details of the delivery, including use of episiotomy. RESULTS: Charts were reviewed for 115 women who delivered in the regional hospital and for 140 women from the rural hospitals. Maternal and infant characteristics did not differ between settings (mean age 26 years, median parity 1, mean birth weight 3433 g [regional] and 3462 g [rural], and mean head circumference 35 cm). Episiotomies were performed in 13% of regional and 4% of rural deliveries (P = .01). Perineal tears occurred in 65% of regional (3 with third- to fourth-degree tears) and 57% of rural (2 with third- to fourth-degree tears) deliveries (P = .20). Deliveries were carried out by 12 FPs and 6 obstetricians in the regional centre, and by 19 FPs in the rural hospitals. CONCLUSION: In our study, both rural and regional practitioners in southern Alberta demonstrated a "restrictive" use of episiotomy, in keeping with current evidence-based guidelines. Further prospective research is needed to examine how physician, maternal, and pregnancy characteristics affect episiotomy and perineal tear rates.
Authors: Michael C Klein; Janusz Kaczorowski; Wendy A Hall; William Fraser; Robert M Liston; Sahba Eftekhary; Rollin Brant; Louise C Mâsse; Jessica Rosinski; Azar Mehrabadi; Nazli Baradaran; Jocelyn Tomkinson; Sharon Dore; Patricia C McNiven; Lee Saxell; Kathie Lindstrom; Jalana Grant; Aoife Chamberlaine Journal: J Obstet Gynaecol Can Date: 2009-09
Authors: Christian Dannecker; Peter Hillemanns; Alexander Strauss; Uwe Hasbargen; Hermann Hepp; Christoph Anthuber Journal: Acta Obstet Gynecol Scand Date: 2004-04 Impact factor: 3.636
Authors: Yvonne M Cargill; Catherine Jane MacKinnon; Marc-Yvon Arsenault; Elias Bartellas; Sue Daniels; Tom Gleason; Stuart Iglesias; Michael C Klein; Carolyn A Lane; Marie-Jocelyne Martel; Ann E Sprague; Ann Roggensack; Ann Kathleen Wilson Journal: J Obstet Gynaecol Can Date: 2004-08