title: [Assessment of restrictive episiotomy use and impact on perineal tears in the Burgundy's Perinatal Network].
abstract: OBJECTIVE
  To analyse episiotomy and perineal tears rates in Burgundy after French National College of Obstetricians and Gynecologists (CNGOF) guidelines in 2005.
  
  
  METHODS
  Multicenter retrospective study, between 2003-2005 (period 1) et 2012-2014 (period 2), conducted on singletons vaginal deliveries, in cephalic presentation from 37 weeks. We compared the episiotomy rate (ER), and perineal lesions in normal deliveries (ND) and instrumental deliveries (ID) between the two periods.
  
  
  RESULTS
  A total of 74,268 women were included. The overall ER significantly decreased from 35.8 to 16.7% (P<0.01), without increasing third degree perineal tears (0.73% vs. 0.66%) or fourth degree (0.14% vs 0.14%). First degree perineal tears rose (42.1% vs 17.6%, P<0.001), second degree decreased (13.5% vs 20.5%, P<0.001). ER decreased whatever the level of motherhood, healthcare ward, vaginal delivery type, or the instrument used.
  
  
  CONCLUSIONS
  Our study found a strong impact in Burgundy of the French guidelines for the practice of restrictive episiotomy for both ND and for ID without increasing sphincter tears and in decreasing spontaneous morbidity.
authors.affiliation: Service de gynécologie-obstétrique, CHU F.-Mitterand, 14, rue Gaffarel, 21000 Dijon, France. Electronic address: perrine.ginod@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Ginod
authors.affiliation: Service de gynécologie-obstétrique, CHU F.-Mitterand, 14, rue Gaffarel, 21000 Dijon, France.
authors.forename: B
authors.initials: B
authors.lastname: Khallouk
authors.affiliation: Réseau périnatal de Bourgogne, 4, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France.
authors.forename: E
authors.initials: E
authors.lastname: Benzenine
authors.affiliation: Réseau périnatal de Bourgogne, 4, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France.
authors.forename: T
authors.initials: T
authors.lastname: Desplanches
authors.affiliation: Hotel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du Parvis-de-Notre-Dame, 75004 Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Dub
authors.affiliation: Service de gynécologie-obstétrique, CHU F.-Mitterand, 14, rue Gaffarel, 21000 Dijon, France.
authors.forename: E
authors.initials: E
authors.lastname: Schmutz
authors.affiliation: Service de gynécologie-obstétrique, CHU F.-Mitterand, 14, rue Gaffarel, 21000 Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Douvier
authors.affiliation: Service de gynécologie-obstétrique, CHU F.-Mitterand, 14, rue Gaffarel, 21000 Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Sagot
mesh_terms: D000328:Adult; D004841:Episiotomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D006801:Humans; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology*; D010502:Perineum / Q000293:injuries*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Burgundy perinatal network; Episiotomy; Lésions sphinctériennes; Politique restrictive; Professional guidelines; Recommandations professionnelles; Restrictive policy; Réseau périnatal de Bourgogne; Sphincter tears; Épisiotomie