|Titre :||Reduction of episiotomy rate in Al Wakra Hospital, Doha, Qatar (2020)|
|Auteurs :||Tamara Salama Alshdafat ; Fayrooz Abu Essa ; Marion Kibuka ; Kavin Shiney Anson ; Zeena Martis|
|Type de document :||Article : texte imprimé|
|Dans :||Midirs. Midwifery Digest (Vol. 30, n° 1, march 2020)|
|Article en page(s) :||p. 75-78|
Paramédical (MeSH)Accouchement ; Audit clinique ; Épisiotomie ; Évaluation des pratiques professionnelles ; Guide de bonnes pratiques ; Obstétrique ; Périnée ; Qatar ; Sage-femme
Background: Normal delivery can cause tearing to the vagina and the surrounding tissue and as the baby is born, the tear can extend to the rectum. Tears are repaired surgically but take time to heal. Historically, to facilitate birth and protect the fetus, obstetricians recommended making a surgical cut to the perineum with scissors or a scalpel to prevent tearing. This intervention is known as episiotomy (Smith 2017). In many south-east Asian countries, episiotomy remains a common and routine procedure during delivery. In 2005, Thailand showed the highest episiotomy rate (91%), followed by the Philippines (64%) in comparison to countries such as Australia (17%) and the United States (25%) (Trinh et al 2015).
Aim: To reduce the episiotomy rate to the Technical Working Group & World Health Organization (2008) recommendation about 12% in Al Wakra Hospital we set the target as 20% & to decrease gradually, by 2018.
Methodology: The audit team consisted of two midwives who recorded monthly statistical data in order to monitor the episiotomy rate.
Results: Between 2015-2018 there was a significant reduction in the episiotomy rate at Al Wakra Hospital. In 2015 an average of 50% (1627 out of 3278) of women accessing care in the labour and delivery room underwent episiotomy as part of normal practice. In comparison, in 2016, there was a reduction in episiotomies performed to 38% (1314 out of 3480) and as of 2017, this rate was further reduced to 32% (1193 out of 3725). In 2018, the episiotomy rate was 32.8% (1170 out of 3567).
Conclusion: The hospital's obstetrics and gynecology team consider episiotomy to have a highly negative impact on women. Therefore, they now promote a workplace culture that encourages midwives and staff in the prevention and avoidance of unnecessary episiotomies. It was necessary to establish documented protocols to provide guidance as to when and how to perform an episiotomy.
|Localisation||Section||Support||Cote de rangement||Statut||Disponibilité|
|Bibliothèque Paramédicale||Périodiques||Périodique||MID.DIG 20-1||Empruntable||Disponible|