Factores que influyen en la realización de una episiotomía selectiva en mujeres nulíparas.

Abstract

Objective: To determinate factors affecting the performance of a selective episiotomy in nulliparous women. Methods: A descriptive cross-sectional study was conducted at the Miguel Servet University Hospital (HUMS) of Zaragoza within a sample of 568 nulliparous women. The performance of episiotomy was compared to postpartum variables such as: maternal age, nationality, gestational age, fetal weight, time of birth, fetal sex, analgesia used and professional attending the birth, as well as the existence of tears and pH results fetal umbilical cord artery. Results: The rate of episiotomy in nulliparous women at HUMS of Zaragoza is 62%. Factors influencing the performance of an episiotomy are greater fetal weight (p=0,000), as well as individual professional judgment attending childbirth. Other factors such as gestational age, fetal sex, epidural analgesia, time of birth or nationality do not affect the above mentioned performance. Lack of episiotomy increases first degree perineal tears and, to a lesser extent, the second degree, without causing an increased risk for fetal wellbeing. In addition, it allows the possibility of maintaining the full perineum after birth, mainly among younger women. Conclusions: It would be advisable to revise the protocols of selective policy for episiotomy rate decrease and equalize rates between different professionals.