[What are the epidemiologic data in regard to episiotomy?].
OBJECTIVE
Description of episiotomy rates and current trends in France. Description of episiotomy variation according to medical situations and inter or intra country in obstetrical variation practices.


METHODS
We analyzed the AUDIPOG Perinatal network. The medical literature review used Pubmed and the Cochrane Library databases.


RESULTS
The episiotomy rate has decreased, in France, from 1996-97 to 2002-03. The percentage of episiotomies among nulliparae is 68% and 31% among multiparae. The episiotomy rate increases with maternal age. The risk of perineal traumatism is variable according to women's ethnic background. The risk of episiotomy is linked to obstetrical situations. It remains an international variation of the global episiotomy rate. However, national rates include regional and hospital variations. French data do not find important variations according to hospital administrative status. We found inter professional variations in the literature.


CONCLUSIONS
Episiotomy is a frequent obstetrical intervention in the world and in France. This intervention is linked with variations in obstetrical practice and with other medical factors at the time of delivery. We note a reduction of episiotomy rate in western countries but this reduction is not the same in these countries.
Fédération de Gynécologie-Obstétrique, CHU de Clermont-Ferrand, Maternité de l'Hôtel-Dieu, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand Cedex 1. fvendittelli@chu-clermontferrand.fr
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Vendittelli
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Gallot
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D004841:Episiotomy / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008423:Maternal Age; D010298:Parity; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D011247:Pregnancy; D012307:Risk Factors