|Title: ||Trends and the Risk Factors of Episiotomy use in Thailand: 2003-2007|
|Trends and the Risk Factors of Episiotomy use in Thailand: 2003-2007|
|Author:||Prapawichar, Phat, MNurs, RN|
|P.I. Institution Name:||University of Wollongong|
|Co-Authors:||Allison Shorten, PhD, RN, RM, MSC; Moira Williamson, PhD, RN, RM, MN|
|[Research Presentation] Purpose: Episiotomy is a widely performed procedure during childbirth, despite poor scientific evidence of its benefits. Recent research indicates that episiotomy is associated with an increased risk of severe perineal lacerations and should be performed restrictively yet routine use of this procedure has remained constant in developing countries including Thailand. This study was conducted to examine trends in episiotomy in Thailand and clinical factors associated with the use of episiotomy. Methods: A retrospective study was conducted involving the collection of non-identifiable medical record data covering a random sample of women who delivered vaginally in the years 2003 to 2007, in two government hospitals in Bangkok, Thailand. Anonymous birth record data from 5,137 women were analyzed using descriptive statistics, cross tabulations and logistic regression. Results: From 2003 through 2007 the episiotomy rate in Thailand increased to 85.6 %. The incidence of severe lacerations remained more frequent for women with episiotomy compared with those without episiotomies, 2.09 % versus 1.80 %, respectively. Clinical factors associated with the use of episiotomy were analyzed using a logistic regression model. The study revealed that primiparous women were approximately seven times more likely to undergo episiotomy compared to multiparous women. Baby birth weight > 3000 gram, length of 2nd stage of labour, accoucheur types and hospital were significant factors in the use of episiotomy (p < 0.001).Conclusion: Despite the evidence that 'routine' use of episiotomy confers few if any advantages and may increase the likelihood of third or fourth degree tears, it continues to be performed at high rate in Thailand. Further investigation should focus on strategies to reduce its 'routine' use, consistent with evidence-based practice for maternity care.|
|Repository Posting Date: ||26-Oct-2011 |
|Date of Publication: ||17-Oct-2011 |
|Appears in Collections: ||STTI International Nursing Research Congress|
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