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Article: The practice of episiotomy in public hospitals in Hong Kong
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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
 
AuthorsLam, KW1
Wong, HS2
Pun, TC1
 
Issue Date2006
 
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org.hk
 
CitationHong 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.
 
ISSN1024-2708
2012 SCImago Journal Rankings: 0.255
 
DC FieldValue
dc.contributor.authorLam, KW
 
dc.contributor.authorWong, HS
 
dc.contributor.authorPun, TC
 
dc.date.accessioned2007-10-30T06:27:22Z
 
dc.date.available2007-10-30T06:27:22Z
 
dc.date.issued2006
 
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.
 
dc.description.naturepublished_or_final_version
 
dc.format.extent350612 bytes
 
dc.format.extent907154 bytes
 
dc.format.mimetypeapplication/pdf
 
dc.format.mimetypeapplication/pdf
 
dc.identifier.citationHong Kong Medical Journal, 2006, v. 12 n. 2, p. 94-98 [How to Cite?]
 
dc.identifier.hkuros118897
 
dc.identifier.issn1024-2708
2012 SCImago Journal Rankings: 0.255
 
dc.identifier.openurl
 
dc.identifier.pmid16603774
 
dc.identifier.scopuseid_2-s2.0-33646493035
 
dc.identifier.urihttp://hdl.handle.net/10722/45495
 
dc.languageeng
 
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org.hk
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshEpisiotomy - adverse effects/utilization
 
dc.subject.meshObstetric Labor Complications - epidemiology - etiology
 
dc.subject.meshPerineum - injuries
 
dc.subject.meshPhysician's Practice Patterns
 
dc.subject.meshPregnancy
 
dc.titleThe practice of episiotomy in public hospitals in Hong Kong
 
dc.title香港公立醫院中外陰切開術的應用情況
 
dc.typeArticle
 
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<description.abstract>OBJECTIVE. 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&lt;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.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong
  2. Wellington School of Medicine and Health Sciences