Episiotomy rates from eleven developing countries.
Episiotomy rates from eleven developing countries.
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十一个发展中国家的会阴切开术率。
DOI：
10.1016/j.ijgo.2005.07.013
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Althabe,F
中科院分区：
文献类型：
--
作者：
Kropp,N;Hartwell,T;Althabe,F
会阴切开术;循证实践;从常规分娩和分娩日志或分娩和分娩记录中提取的孕产妇健康数据。研究中心是指报告来自参与全球网络的1个或多个国家的数据的研究团队。会阴切开术发生率按临床试验机构以及各临床试验机构的平均发生率和范围报告。临床试验机构的回复包括每个国家1 - 13家医院的数据，但2家临床试验机构报告了来自1个以上国家的数据。图1显示，除赞比亚外，所有国家的初产妇会阴切开率均高于90%（平均93%;范围91%-100%）。一般来说，所有阴道分娩的会阴切开率低于未经产，但巴西高达80%，除赞比亚外，所有国家均高于20%（平均值为44%;范围为23%-80%），赞比亚报告的未经产率（6.9%）低于所有阴道分娩率（8.5%）。然而，赞比亚只有一家医院的数据。本报告中提供的数据来自参与资助临床研究的选定医院，因此不能泛化。然而，它们说明了常规会阴切开术在发展中国家的广泛使用，并证实了在拉丁美洲观察到的高比率[3]，这与质疑其有效性的证据相矛盾。关于西藏、印度、赞比亚和刚果的外阴切开率的公开数据还没有现成的。不必要的会阴切开术增加了发病的风险，包括会阴后损伤，
Episiotomy; Evidence-based practice; Maternal health data extracted from routine labor and delivery logbooks or from labor and delivery records. A site refers to an investigative team reporting data from 1 or more countries participating in the Global Network. Episiotomy rates are reported both by site and by mean rates and ranges across sites. Site responses included data from 1 to 13 hospitals per country, but 2 sites reported data from more than 1 country. Fig. 1 shows that episiotomy rates among nulliparas were higher than 90%(mean, 93%; range, 91%—100%) in all countries except Zambia. In general, reported episiotomy rates for all vaginal births are lower than for nulliparous only, but are as high as 80% in Brazil and higher than 20% in all countries (mean, 44%; range, 23%—80%) except Zambia, which reported a lower rate for nulliparous (6.9%) than for all vaginal births (8.5%). However, data from Zambia were available for only 1 hospital. The data presented in this report were obtained from selected hospitals participating in funded clinical research studies, and thus cannot be generalized. However, they illustrate the widespread use of routine episiotomy in developing countries and confirm the high rates observed in Latin America [3], in contradiction to the evidence questioning its efficacy. Published data on episiotomy rates for Tibet, India, Zambia, and Congo are not readily available. Unnecessary episiotomies increase the risk of morbidity, including posterior perineal trau-