Skip to main content
Erschienen in: International Urogynecology Journal 9/2020

31.01.2020 | Review Article

Impact of the EPISCISSORS-60 mediolateral episiotomy scissors on obstetric anal sphincter injuries: a 2-year data review in the United Kingdom

verfasst von: Li Mei Koh, Yves van Roon, Ashish Pradhan, Sangeeta Pathak

Erschienen in: International Urogynecology Journal | Ausgabe 9/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

This time-series analysis was carried out to determine if the use of the EPISCISSORS-60®, episiotomy scissors specifically designed to achieve a cutting angle of 60°, would continue to sustain obstetric anal sphincter injuries (OASIS) reductions at our hospital 2 years after its introduction.

Methods

We compared data from 2,342 women delivered in 2014 (prior to the introduction of EPISCISSORS-60®) with that of 4,498 women delivered from 2016 to 2017 (after the introduction of EPISCISSORS-60®).

Results

There was a reduction of OASIS in all nulliparous vaginal deliveries (NVD; 7.2% vs 5.1% p = 0.05), and a 50% reduction of OASIS (7.5% vs 3.7%) in operative vaginal deliveries (OVD) (p = 0.02). There was a statistically significant association between episiotomies performed with EPISCISSORS-60® and a reduction in OASIS (SVD: 6.9% vs 1.5% p = 0.006; OVD:28.6% vs 2.6% p < 0.0001). Additionally, there was an increase in the use of episiotomies in all nulliparous vaginal deliveries (29% vs 33.7%; p = 0.01). We also found a 78% reduction of OASIS with episiotomies compared with no episiotomies in the 2016–2017 group (6.9% vs 1.5% p = 0.006).

Conclusions

Our results suggest that there might have been a sustained reduction in OASIS rates associated with using EPISCISSORS-60®.
Literatur
5.
Zurück zum Zitat Fritel X, Schaal JP, Fauconnier A, Bertrang V, Levet C, Pigne A. Pelvic floor disorders 4 years after first delivery: a comparative study of restrictive versus systematic episiotomy. BJOG. 2008;115:247–52.CrossRef Fritel X, Schaal JP, Fauconnier A, Bertrang V, Levet C, Pigne A. Pelvic floor disorders 4 years after first delivery: a comparative study of restrictive versus systematic episiotomy. BJOG. 2008;115:247–52.CrossRef
9.
Zurück zum Zitat Eogan M, Daly L, O'Connell PR, O'Herlihy C. Does the angle of episiotomy affect the incidence of anal sphincter injury? BJOG. 2006;113:190–4.CrossRef Eogan M, Daly L, O'Connell PR, O'Herlihy C. Does the angle of episiotomy affect the incidence of anal sphincter injury? BJOG. 2006;113:190–4.CrossRef
11.
Zurück zum Zitat Andrews V, Thakar R, Sultan AH, Jones PW. Are mediolateral episiotomies actually mediolateral? BJOG. 2005;112:1156–8.CrossRef Andrews V, Thakar R, Sultan AH, Jones PW. Are mediolateral episiotomies actually mediolateral? BJOG. 2005;112:1156–8.CrossRef
17.
Zurück zum Zitat Van Roon Y, Kirwin C, Rahman N, Vinayakarao L, Melson L, Kester N, et al. Comparison of obstetric anal sphincter injuries in nulliparous women before and after introduction of the EPISCISSORS-60 at two hospitals in the United Kingdom. Int J Women’s Health. 2015;7:949–55.CrossRef Van Roon Y, Kirwin C, Rahman N, Vinayakarao L, Melson L, Kester N, et al. Comparison of obstetric anal sphincter injuries in nulliparous women before and after introduction of the EPISCISSORS-60 at two hospitals in the United Kingdom. Int J Women’s Health. 2015;7:949–55.CrossRef
18.
Zurück zum Zitat Mohiudin H, Ali S, Pisal PN, Villar R. Implementation of the RCOG guidelines for prevention of obstetric anal sphincter injuries (OASIS) at two London hospitals: a time series analysis. Eur J Obstet Gynecol Reprod Biol. 2018;224:89–92.CrossRef Mohiudin H, Ali S, Pisal PN, Villar R. Implementation of the RCOG guidelines for prevention of obstetric anal sphincter injuries (OASIS) at two London hospitals: a time series analysis. Eur J Obstet Gynecol Reprod Biol. 2018;224:89–92.CrossRef
22.
Zurück zum Zitat Laine K, Skjeldestad FE, Sandvik L, Staff AC. Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study. BMJ Open. 2012;2:e001649.CrossRef Laine K, Skjeldestad FE, Sandvik L, Staff AC. Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study. BMJ Open. 2012;2:e001649.CrossRef
Metadaten
Titel
Impact of the EPISCISSORS-60 mediolateral episiotomy scissors on obstetric anal sphincter injuries: a 2-year data review in the United Kingdom
verfasst von
Li Mei Koh
Yves van Roon
Ashish Pradhan
Sangeeta Pathak
Publikationsdatum
31.01.2020
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 9/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-019-04201-7

Weitere Artikel der Ausgabe 9/2020

International Urogynecology Journal 9/2020 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.