Curved versus straight scissors to avoid 3rd and 4th degree perineal tears: A randomised feasibility study |
| |
| Authors: | Angela Swift Joan Webster Annette Mary Conroy Sue Hampton Sarah Jane Kirby Lee Minuzzo Rebecca Kimble |
| |
| Affiliation: | 1. Department of Nursing, Mid Sweden University, SE-851 70 Sundsvall, Sweden;2. Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, SE-118 83 Stockholm, Sweden;3. Department of Women''s and Children''s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden;4. Department of Women''s and Children''s Health, Uppsala University, SE-751 85 Uppsala, Sweden;5. School of Nursing and Midwifery, Maternity and Family Unit, Research Centre for Clinical and Community Practice Innovation (RCCCPI), Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia;6. Gold Coast Hospital, Queensland 4215, Australia;1. Osaka University, Graduate School of Medicine, Division of Health Sciences, 1-7 Yamadaoka, Suita, Osaka, Japan;2. Saitama Medical University, Saitama Medical Center, Center for Maternal, Fetal and Neonatal Medicine, 1981 Kamoda, Kawagoe, Saitama, Japan;1. Heartlands Hospital, Heart of England Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK;2. Queen Elizabeth Hospital Birmingham, University Hospital Birmingham, Edgbaston, Birmingham B15 2TH, UK;3. School of Health & Population Sciences, Public Health Building, University of Birmingham, Birmingham B15 2TT, UK;4. Princess of Wales Women''s Unit, Heartlands Hospital, Heart of England Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK;1. Nutrition and Dietetics, Logan Hospital, Queensland Health, Meadowbrook, QLD 4131, Australia;2. Department of Nutrition and Dietetics, Mater Mothers’ Hospital, QLD 4101, Australia;3. Mater Medical Research Institute, QLD 4101, Australia |
| |
| Abstract: | ![]()
BackgroundSevere perineal tears sustained during childbirth cause significant distress and morbidity amongst women. The objective of this study was to compare the use of straight scissors for cutting an episiotomy with the use of curved scissors, which are designed to curve away from the anal sphincter.MethodsWe used a single-centre, randomised feasibility trial. The intervention was the use of curved scissors. Women were recruited during a prenatal visit and randomised in the delivery suite, when it became clear that an episiotomy was required. The feasibility outcomes were the proportion of women able to be recruited, randomised and followed up. We also calculated the incidence of obstetric anal sphincter injury when either straight or curved scissors were used to cut an episiotomy. Other outcomes assessed were pain, length of hospital stay, perineal infection and perineal dehiscence.ResultsOf the 155 patients recruited in the prenatal period, only 20 (12.9%) were eventually randomised at birth. The main reasons for the high loss were that women either did not have a vaginal delivery (38, 24.5%), or they did not need an episiotomy (72, 46.5%). Rates of obstetric anal sphincter injury and other outcomes were similar between groups.DiscussionAnal sphincter injury during childbirth remains an important problem. Although the use of curved scissors provides a theoretical solution, we found that the high attrition rate made feasibility of conducting a suitably powered, randomised trial using the current design untenable. Alternative strategies have been suggested to make any future study more viable. |
| |
| Keywords: | Episiotomy 3rd degree tear 4th degree tear Obstetric anal sphincter injury Scissors |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
