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. 2024 Jul 9;75(2):4216.
doi: 10.18597/rcog.4216.

Frequency of episiotomy practice in an institution in Quito, Ecuador 2009-2022

[Article in English, Spanish]
Mercy Dolores Rosero-Quintana  1 , Santiago Vasco-Morales  2 , Karla Benalcázar-Sanmartín  1 , Liseth Paola Salazar-Congacha  1 , Paola Cristina Toapanta-Pinta  1
Affiliations

Frequency of episiotomy practice in an institution in Quito, Ecuador 2009-2022

[Article in English, Spanish]
Mercy Dolores Rosero-Quintana et al. Rev Colomb Obstet Ginecol. .

Abstract
in English, Spanish

Objectives: To determine the prevalence of episiotomy over a 14-year period and to explore its association with maternal, delivery, and neonatal variables using administrative data.

Material and methods: This is a cross-sectional study. Women who had a vaginal delivery with a live newborn at a referral hospital for obstetric care in Ecuador were included. Consecutive sampling was employed. ICD-10 records and the perinatal information system (PIS) were utilized. Sociodemographic, gestational, delivery, and neonatal variables were assessed. Descriptive analysis was performed. The overall and yearly prevalence was determined. Exploratory bivariate and multivariate analyses were conducted. The study was approved by the Human Research Ethics Committee of the Universidad Central del Ecuador.

Results: A total of 11,862 records were analyzed. The overall prevalence of episiotomy was 36.69 %, with a maximum of 42 % and a minimum of 28 %. There is an implied trend towards a reduction in frequency from 2019 to 2022. A positive association was found between episiotomy and maternal age under 20 years, previous cesarean section, absence of a companion during delivery, term newborns, and large for gestational age newborns. A negative association was found with previous vaginal deliveries.

Conclusions: The prevalence of episiotomy exceeds the recommendation of the World Health Organization (WHO). Clinical practice guidelines should consider potentially modifiable maternal and neonatal factors in their recommendations. Prospective studies should be conducted to evaluate the safety of the procedure, confirm these observations, and use robust methodologies to assess if there is a real decrease in its practice.

Objetivo: determinar la prevalencia de episiotomía en un periodo de tiempo de 14 años, y explorar su asociación con variables maternas, del parto y los resultados neonatales mediante la utilización de datos administrativos. Materiales y métodos: estudio transversal. Se incluyeron mujeres que tuvieron parto vaginal con recién nacido vivo, en una institución hospitalaria de referencia en atención obstétrica en Ecuador. Muestreo consecutivo. Se utilizaron los registros CIE-10 y del sistema informático perinatal (SIP), se evaluaron las variables sociodemográficas, de la gestación, el parto y neonatales. Análisis descriptivo. Se determinó la prevalencia global y por año. Se realizó análisis exploratorio bivariado y multivariado. Estudio aprobado por el Comité de Ética en Investigación en Seres Humanos de la Universidad Central del Ecuador.

Resultados: se analizaron 11.862 datos. La prevalencia global de episiotomía fue del 36,69%, con un máximo del 42 % y un mínimo del 28 %. Se insinúa una tendencia a la reducción de la frecuencia desde 2019 a 2022. Se encontró una asociación positiva entre su realización y la edad materna menor a 20 años, cesárea previa, ausencia de acompañante durante el parto, recién nacido a término, y grande para la edad gestacional. Se halló una asociación negativa con partos vaginales anteriores.

Conclusiones: la prevalencia de episiotomía supera la recomendación de la Organización Mundial de la Salud (OMS). Las guías de práctica clínica, en sus recomendaciones, deben considerar los factores maternos y neonatales asociados, potencialmente modificables. Se deberán realizar estudios prospectivos para evaluar la seguridad del procedimiento, confirmar estas observaciones y utilizar metodologías robustas para evaluar si hay una disminución real en su práctica.

Keywords: Episiotomy; Natural childbirth; Surgical wound; Maternal health; Prevalence; Obstetrics; Gynecology.

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Conflict of interest statement

Conflicto de intereses: los autores declaran no tener ningún conflicto de intereses.

Figures

Figura 1
Figura 1. Flujograma de pacientes.
Figura 1
Figura 1. Proporción de episiotomías en el Hospital Gineco-Obstétrico Isidro Ayora (HGOIA), 2009-2022.
See this image and copyright information in PMC

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