[Prevalence and factors associated with practice of episiotomy at a maternity school in Recife, Pernambuco, Brazil].
OBJECTIVE
To determine the prevalence and factors associated with episiotomy in a reference center of Pernambuco.


METHODS
A retrospective cross-sectional study was carried out from January to December 2006 with 495 women who had a normal delivery at the Maternity Center Monteiro de Moraes Integrated Health Amaury de Medeiros (CISAM) University of Pernambuco. Assessed factors were issues preceeding birth, characteristics of labor and perinatal outcome. To verify the association between predictors and performance of episiotomy the Chi square, Fisher's exact and Student's t tests were used as appropriate, with a a significance level of 5%. The prevalence ratio and confidence intervals were calculated at 95%, in addition to logistic regression analysis.


RESULTS
Prevalence of performing episiotomy was 29.1% (n = 144). After bivariate analysis, we found a significant association of episiotomy with adolescence (PR 1.74. 95% CI 1.33-2.28), age over 35 years (PR 0.35. 95% CI 0.14-0.90), primiparity (PR 4.73, 95% CI 3.33-6.71), absence of previous vaginal delivery (PR 5.44, 95% CI 3.67-8.06) and related diseases at the time of delivery (RP 1.71, 95% CI 1.30-2.25). There was no significant relation with gestational age at delivery, duration of labor over 6h and expulsion period of more than 30 minutes, use of misoprostol or oxytocin, abnormal fetal heart rate, presence of meconium, shift of completion of delivery (night or day), rate of Apgar score in 1 and 5 minutes and weight of the newborn. Presence of perineal lacerations was higher in the group not subject to episiotomy, however only 1st and 2nd degree lacerations were described. After logistic regression, the analyzed remaining factors associated with episiotomies were maternal diseases (RA 1.99, 95% CI 1.20-3.28) and absence of previous vaginal delivery (9.85 RA, 95% CI 6.04-16.06).


CONCLUSIONS
Prevalence of episiotomies in the institution was 29%. Variables that remained related to episiotomy were maternal diseases and absence of previous vaginal delivery.
Carvalho
Cynthia Coelho Medeiros de
CC
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE. cynthiacoelho@ibest.com.br
Souza
Alex Sandro Rolland
AS
Moraes Filho
Olímpio Barbosa
OB
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000145:classification; D004812:Epidemiologic Methods; D004841:Episiotomy / Q000706:statistics & numerical data*; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012577:Schools, Medical; D055815:Young Adult