Episiotomía selectiva frente a episiotomía rutinaria. Valoración a los 3 años (2007-2008)

Luque-Carro, Raquel; Subirón-Valera, Ana Belén; Sabater-Adán, Belén; de Miguel, Encarna Sanz; Juste-Pina, Amelia; Cruz-Guerreiro, Esther
March 2011
Matronas Profesion;2011, Vol. 12 Issue 1, p41
Objective: To identify, three-year postpartum, the results of the usage of episiotomy according to either a restrictive protocol or a systematic protocol. Subjects and method: Experimental prospective study undertaken at Miguel Servet Hospital in Zaragoza in first stage in the years 2004-2005 and in second stage after 3 years postpartum. The patients are nulliparous women; childbirth is eutocic to term, assisted by midwife. In this second stage, posterior gestations and type of birth, residual perineal pain, urinary pain, defecation pain or coital pain, urinary incontinence (UI), type and frequency, fecal incontinence, sexual satisfaction, execution of pelvic floor exercises and breastfeeding are assessed. Results: 365 women were interviewed, 185 (50.68%) from the control group and 180 (49.32%) from the experimental group. In the control group 156 (84.32%) received episiotomy and 29 (15.68%) did not. In the experimental group, 108 (60.0%) women received episiotomy and 72 (40.0%) did not (p <0.001). 184 women showed posterior gestation and 181 did not, with no statistical significance in either of the studied groups: control or experimental, or with episiotomy-without episiotomy. No statistical differences were found, in the control groups-experimental or with episiotomy-without episiotomy, in either of the assessed variables. Of the 9 genital prolapse diagnosed cases, 8 happened in the 184 women with posterior gestation (4.3%), and 1 in the group of 181 women without posterior gestation (0.6%) (p= 0.040). Conclusions: The routinary episiotomy does not protect from pelvic floor disorders, sexual interaction or UI 3 years after childbirth.


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