title: Episiotomy at the Royal Women's Hospital, Brisbane: a comparison of practices in 1986 and 1992.
abstract: OBJECTIVE
  to determine whether the incidence of perineal outcomes, including episiotomy, at the Royal Women's Hospital (RWH) Brisbane reflected trends reported in the literature.
  
  
  METHODS
  retrospective record review.
  
  
  METHODS
  RWH Brisbane.
  
  
  METHODS
  953 women who delivered vaginally at the RWH in 1986 and 1992.
  
  
  RESULTS
  there was a decline in the episiotomy rate from 65% in 1986 to 36% in 1992. This was accompanied by an increase in the incidence of intact perinea and spontaneous perineal tears. There was no difference in the incidence of spontaneous third degree tears. The decline in the incidence of episiotomy was found when other factors, such as parity, were considered, with the exception of operative vaginal delivery, where no difference in the use of episiotomy was found. There was no significant increase in the number of babies with an Apgar score of < 7 at one minute of age, despite a significant reduction in the use of episiotomy when delivering these babies (55% in 1986 and 19% in 1992; P < 0.001). The second stage was significantly longer in 1992 (P < 0.01).
  
  
  CONCLUSIONS
  the findings reflect the decline in the incidence of episiotomy reported in the literature. This decline in rate was accompanied by an increase in the length of second stage and in the incidence of both intact perinea and perineal tears. Lowering the incidence of episiotomy did not result in a rise in the rate of babies with an Apgar score of < 7 at one minute.
authors.forename: C
authors.initials: C
authors.lastname: East
authors.forename: J
authors.initials: J
authors.lastname: Webster
mesh_terms: D000293:Adolescent; D000328:Adult; D004739:England; D004841:Episiotomy / Q000009:adverse effects / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D015994:Incidence; D017063:Outcome Assessment, Health Care; D010502:Perineum / Q000293:injuries; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D011247:Pregnancy