Obstetric anal sphincter injuries before and after the introduction of the Episcissors-60: A multi-centre time series analysis.

Ayuk, Paul, Farnworth, Allsin, Rees, Jon, Khunda, Aehthele, Edmundson, Dawn, Raheja, Vinita, Ullal, Aarti, Ravimohan, Velauthapillai, Lu, Ena and Robson, SC (2019) Obstetric anal sphincter injuries before and after the introduction of the Episcissors-60: A multi-centre time series analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 241. pp. 94-98. ISSN 0301-2115

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Abstract

Abstract
Obstetric anal sphincter injuries before and after the introduction of the Episcissors-60: A multi-centre time series analysis.
Paul Ayuk , Allison Farnworth , Jon Rees , Aethele Khunda , Dawn Edmundson , Vinita Raheja , Aarti Ullal , Velauthapillai Ravimohan , Ena Lu , S C Robson

Objective
To investigate the impact of the Episcissors-60 on obstetric anal sphincter injury (OASI) rates.
Study design
Observational multi-centre time series analysis at four maternity units in the North-East of England. The main outcome measures were obstetric anal sphincter injury rates and delivery blood loss
Results
Data were analysed for women who had a vaginal birth of a singleton pregnancy before (11,192) and after (8,064) the introduction of the Episcissors-60. There were 2115 episiotomies before and 1498 after the introduction of the Episcissors-60, of which 1311 (87.5%) were undertaken with the Episcissors-60, 114 (7.6%) with other scissors and the scissors used were not stated in 73 (4.8%) women. There was no significant association between the introduction of Episcissors-60 and the performance of an episiotomy (χ2 = 0.006, p = 0.94). Episiotomy was associated with a significant reduction in OASI rates (1.9% Vs 2.8%, odds ratio = 0.67 [0.51 – 0.86]; p = 0.001). There was no significant association between the introduction of the Episcissors-60 and the occurrence of OASIs in all women (χ2 = 0.6, p= 0.46) or in women who had an episiotomy (χ2 = 0.20, p = 0.71). In women who had an episiotomy, the mean estimated delivery blood loss was 550.3 ± 8.2 ml before and 598.8 ± 10.9 ml after the introduction of the Episcissors-60 (p < 0.001).
Conclusion
Introduction of the Episcissors-60 was not associated with a change in OASI or episiotomy rates but may be associated with a small increase in delivery blood loss.

Key words: Episcissors-60, obstetric anal sphincter injury

Item Type: Article
Subjects: Sciences > Health Sciences
Divisions: Faculty of Health Sciences and Wellbeing
Faculty of Health Sciences and Wellbeing > School of Psychology
Related URLs:
Depositing User: Jon Rees
Date Deposited: 23 Sep 2019 10:46
Last Modified: 04 Sep 2020 13:55
URI: http://sure.sunderland.ac.uk/id/eprint/11133
ORCID for Jon Rees: ORCID iD orcid.org/0000-0002-3295-244X

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