Abstract
Objective
To investigate the impact of the Episcissors-60 on obstetric anal sphincter injury
(OASI) rates.
Study design
Observational multi-centre time series analysis at four maternity units in the North-East
of England. The main outcome measures were obstetric anal sphincter injury rates and
delivery blood loss.
Results
Data were analysed for women who had a vaginal birth of a singleton pregnancy before
(11,192) and after (8064) the introduction of the Episcissors-60. There were 2115
episiotomies before and 1498 after the introduction of the Episcissors-60, of which
1311 (87.5%) were undertaken with the Episcissors-60, 114 (7.6%) with other scissors
and the scissors used were not stated in 73 (4.8%) women. There was no significant
association between the introduction of Episcissors-60 and the performance of an episiotomy
(χ2 = 0.006, p = 0.94). Episiotomy was associated with a significant reduction in OASI rates (1.9%
Vs 2.8%, odds ratio = 0.67 [0.51 – 0.86]; p = 0.001). There was no significant association between the introduction of the Episcissors-60
and the occurrence of OASIs in all women (χ2 = 0.6, p = 0.46) or in women who had an episiotomy (χ2 = 0.20, p = 0.71). In women who had an episiotomy, the mean estimated delivery blood loss was
550.3 ± 8.2 ml before and 598.8 ± 10.9 ml after the introduction of the Episcissors-60
(p < 0.001).
Conclusion
Introduction of the Episcissors-60 was not associated with a change in OASI or episiotomy
rates but may be associated with a small increase in delivery blood loss.
Keywords
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Article info
Publication history
Published online: August 27, 2019
Accepted:
August 26,
2019
Received in revised form:
August 23,
2019
Received:
July 2,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier B.V. All rights reserved.
