Episiotomy preferences, indication, and classification--a survey among Nordic doctors

Area of Science:

• Obstetrics and Gynecology
• Surgical Techniques
• Patient Safety

Background:

• Episiotomy practices significantly influence perineal health outcomes.
• Rates of obstetric anal sphincter injuries (OASIS) are a key concern in obstetrics.
• Understanding physician practices is crucial for improving surgical outcomes.

Purpose of the Study:

• To assess self-reported episiotomy techniques among Nordic physicians.
• To evaluate physician opinions on the clinical indications for episiotomy.
• To identify potential misclassification of episiotomy types.

Main Methods:

• A survey was conducted among 297 physicians at a 2012 Nordic obstetrical and gynecological conference.
• Participants drew their preferred episiotomy technique on a perineal diagram and named it.
• Outcomes were compared based on country and seniority.

Main Results:

• 47% of participants drew a lateral episiotomy, but 64% misclassified it as mediolateral.
• Only 20% drew a mediolateral episiotomy, with minimal misclassification.
• One-third of drawn episiotomies were unclassifiable, and significant country-based variations in technique preference and indication perception were observed.

Conclusions:

• Wide variation in self-reported episiotomy performance and high misclassification rates among Nordic physicians necessitate educational interventions.
• Standardized classification systems and appropriate surgical techniques are vital for research into preventing OASIS.
• Targeted training can improve consistency and accuracy in episiotomy procedures.