Risk factors for mediolateral episiotomy at a tertiary hospital: a cross-sectional study

Author(s)

Rafael Coelho de Albuquerque ^[1] ; Gláucia Miranda Varella Pereira ^[2] ; Adriana Gomes Luz ^[3] ; Marina Augusto Nóbrega ^[4] ; Giuliane Jesus Lajos ^[5] ; Luiz Gustavo Oliveira Brito ^[6]

Affiliation

^[1] Universidade de Campinas. School of Medical Sciences. Department of Obstetrics and Gynecology - Brasil

^[2] Universidade de Campinas. School of Medical Sciences. Department of Obstetrics and Gynecology - Brasil

^[3] Universidade de Campinas. School of Medical Sciences. Department of Obstetrics and Gynecology - Brasil

^[4] Universidade de Campinas. School of Medical Sciences. Department of Obstetrics and Gynecology - Brasil

^[5] Universidade de Campinas. School of Medical Sciences. Department of Obstetrics and Gynecology - Brasil

^[6] Universidade de Campinas. School of Medical Sciences. Department of Obstetrics and Gynecology - Brasil

• Document type: Journal article
• Source: Revista da Associação Médica Brasileira; v. 68, n. 4, p. 463-469, 2022-05-25.

Abstract

SUMMARY OBJECTIVE: The main aim of this study was to assess the associated factors for selective mediolateral episiotomy at a tertiary, academic hospital. METHODS: A retrospective cohort analysis between 2017 and 2019 was performed. The primary outcome was the prevalence of selective mediolateral episiotomy. Independent variables were maternal, intrapartum, and neonatal characteristics. A significance level of 5% was established, and univariate and multivariate analyses with logistic regression models were performed. RESULTS: From 2,761 vaginal deliveries eligible for inclusion during this period, the prevalence of selective mediolateral episiotomy was 18.7%. Univariate analysis has shown that non-white women were protective factors (OR=0.77 [0.63–0.96]; p=0.02) for episiotomy; primiparity (OR=2.61 [2.12–3.21]; p<0.01), number of vaginal examinations between 6–10 repetitions (OR=3.16 [2.48–4.01]; p<0.01) and 11–20 repetitions (OR=5.40 [3.69–7.90]; p<0.01), longer second stage duration (OR=1.01 [1.00–1.02]; p<0.01), and women with gestational age more than 37 weeks were risk factors. Multivariate analysis reported that second stage duration (AOR=1.01 [1.00–1.03]; p<0.01), primiparity (AOR=2.03 [1.34–3.06]; p<0.01), and number of vaginal examinations between 6–10 repetitions (AOR=2.36 [1.50–3.70]; p<0.01) and 11–20 repetitions (AOR=3.29 [1.74–6.20]; p<0.01) were remained as risk factors for selective mediolateral episiotomy. CONCLUSION: A higher number of vaginal examinations during labor (over six repetitions), longer duration of second stage labor, and primiparity were risk factors associated with selective mediolateral episiotomy. (AU)

• FAPESP's process: 19/26723-5 - Effect of fractional microablative radiofrequency and pelvic floor muscle training in the treatment of women with of vaginal laxity: randomized clinical trial
• Grantee: Glaucia Miranda Varella Pereira
• Support Opportunities: Scholarships in Brazil - Doctorate