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Article: The practice of episiotomy in public hospitals in Hong Kong

TitleThe practice of episiotomy in public hospitals in Hong Kong
香港公立醫院中外陰切開術的應用情況
Authors
Issue Date2006
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org.hk
Citation
Hong Kong Medical Journal, 2006, v. 12 n. 2, p. 94-98 How to Cite?
AbstractOBJECTIVE. To review the use of episiotomy during vaginal delivery in Hong Kong public hospitals. DESIGN. Prospective observational survey. SETTING. Public hospitals, Hong Kong. PARTICIPANTS. Women who underwent normal vaginal delivery of a singleton foetus with cephalic presentation. MAIN OUTCOME MEASURES. Number of women having an episiotomy, severe-degree (third- or fourth-degree) tear, other types of tear, blood loss at delivery, postpartum haemorrhage, need for blood transfusion, puerperal pyrexia, wound infection, gaping wound that required suture removal, and drainage or resuturing of a perineal wound. RESULTS. Between 1 January and 31 March 2003, there were 6222 singleton spontaneous normal vaginal deliveries in the public hospitals of Hong Kong. Of the 6167 women in whom the status of the perineum was known, episiotomy was performed in 5274 (85.5%). Primiparous women were more likely to undergo episiotomy at delivery than multiparous women (97.9% vs 71.4%). Women with episiotomy had significantly less perineal tearing of any kind than those without. The occurrence of any type of perineal tear and severe-degree (third- or fourth-degree) tear was significantly lower in primiparous women who had an episiotomy than those without (P<0.05). Women with episiotomy had increased mean blood loss at delivery but other complications were not significantly increased. CONCLUSIONS. In Hong Kong, episiotomy is routinely performed during normal vaginal delivery. It is associated with a significantly lower overall rate of perineal tearing. This study was observational, nonetheless the occurrence of other complications was likely to increase when episiotomy was performed. Firm evidence from several randomised controlled studies shows that routine episiotomy is unjustified and possibly harmful. Routine episiotomy should not be promoted in Hong Kong without further randomised controlled study.
Persistent Identifierhttp://hdl.handle.net/10722/45495
ISSN
2014 Impact Factor: 0.872
2013 SCImago Journal Rankings: 0.293

 

DC FieldValueLanguage
dc.contributor.authorLam, KWen_HK
dc.contributor.authorWong, HSen_HK
dc.contributor.authorPun, TCen_HK
dc.date.accessioned2007-10-30T06:27:22Z-
dc.date.available2007-10-30T06:27:22Z-
dc.date.issued2006en_HK
dc.identifier.citationHong Kong Medical Journal, 2006, v. 12 n. 2, p. 94-98en_HK
dc.identifier.issn1024-2708en_HK
dc.identifier.urihttp://hdl.handle.net/10722/45495-
dc.description.abstractOBJECTIVE. To review the use of episiotomy during vaginal delivery in Hong Kong public hospitals. DESIGN. Prospective observational survey. SETTING. Public hospitals, Hong Kong. PARTICIPANTS. Women who underwent normal vaginal delivery of a singleton foetus with cephalic presentation. MAIN OUTCOME MEASURES. Number of women having an episiotomy, severe-degree (third- or fourth-degree) tear, other types of tear, blood loss at delivery, postpartum haemorrhage, need for blood transfusion, puerperal pyrexia, wound infection, gaping wound that required suture removal, and drainage or resuturing of a perineal wound. RESULTS. Between 1 January and 31 March 2003, there were 6222 singleton spontaneous normal vaginal deliveries in the public hospitals of Hong Kong. Of the 6167 women in whom the status of the perineum was known, episiotomy was performed in 5274 (85.5%). Primiparous women were more likely to undergo episiotomy at delivery than multiparous women (97.9% vs 71.4%). Women with episiotomy had significantly less perineal tearing of any kind than those without. The occurrence of any type of perineal tear and severe-degree (third- or fourth-degree) tear was significantly lower in primiparous women who had an episiotomy than those without (P<0.05). Women with episiotomy had increased mean blood loss at delivery but other complications were not significantly increased. CONCLUSIONS. In Hong Kong, episiotomy is routinely performed during normal vaginal delivery. It is associated with a significantly lower overall rate of perineal tearing. This study was observational, nonetheless the occurrence of other complications was likely to increase when episiotomy was performed. Firm evidence from several randomised controlled studies shows that routine episiotomy is unjustified and possibly harmful. Routine episiotomy should not be promoted in Hong Kong without further randomised controlled study.en_HK
dc.format.extent350612 bytes-
dc.format.extent907154 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/pdf-
dc.languageengen_HK
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org.hken_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshEpisiotomy - adverse effects/utilizationen_HK
dc.subject.meshObstetric Labor Complications - epidemiology - etiologyen_HK
dc.subject.meshPerineum - injuriesen_HK
dc.subject.meshPhysician's Practice Patternsen_HK
dc.subject.meshPregnancyen_HK
dc.titleThe practice of episiotomy in public hospitals in Hong Kongen_HK
dc.title香港公立醫院中外陰切開術的應用情況zh_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=12&issue=2&spage=94&epage=98&date=2006&atitle=The+practice+of+episiotomy+in+public+hospitals+in+Hong+Kongen_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid16603774en_HK
dc.identifier.scopuseid_2-s2.0-33646493035-
dc.identifier.hkuros118897-

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