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Influence of training in the use and generation of evidence on episiotomy practice and perineal trauma
Author(s) -
Ho Jacqueline J.,
Pattanittum Porjai,
Japaraj Robert P.,
Turner Tari,
Swadpanich Ussanee,
Crowther Caroline A.
Publication year - 2010
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2010.04.035
Subject(s) - medicine , episiotomy , childbirth , perineum , obstetrics , confidence interval , pregnancy , intervention (counseling) , retrospective cohort study , gynecology , nursing , surgery , genetics , biology
Abstract Objective To examine episiotomy practices before and after a multi‐component intervention designed to support the use and generation of research evidence in maternal and neonatal health care. Methods Set in 9 centers across 4 Southeast Asian countries, a retrospective survey was performed for 12 recommended pregnancy/childbirth practices and 13 outcomes of women in each center before and after intervention. Qualitative interviews were conducted to assess staff awareness and experience in evidence‐based practice. Results There were significant decreases in the rate of episiotomy, from 64.1% to 60.1% (risk difference [RD] –4.0; 95% confidence interval [CI], –5.8 to –2.2) for all women and from 92.2% to 80.7% (RD –11.5; 95% CI, –13.4 to –9.6) for nulliparous women. Severe trauma decreased from 3.9% to 1.9% (RD –2.0; 95% CI, –2.7 to –1.4) for all women and from 6.7% to 3.0% (RD –3.7; 95% CI, –4.9 to –2.5) for nulliparous women. The frequency of intact perineum increased from 12.4% to 15.6% (RD 3.2; 95% CI, 1.9–4.6) for all women and from 1.7% to 8.0% (RD 6.3; 95% CI, 5.0–7.5) for nulliparous women. Conclusion An intervention based on understanding and using the best available evidence can result in significant improvements in care and health outcomes.