[National survey about the practice of episiotomy within French National College of Obstetricians and Gynecologists (CNGOF)]

Abstract

Objective: The main endpoint was to perform a survey about the practices of episiotomy into a CNGOF (National College of French Obstetricians and Gynecologists) members population.

Methods: In November 2018, it was proceeded to a national survey from CNGOF members thanks to an online questionnaire. We collected prospectively: the answerer's characteristics, the rate of episiotomy and its systematics indications for spontaneous and operative delivery, the habits of the practitioners for the section and the reparation, the modalities of women's information and the data entered into the medical record.

Results: Three hundred and eighty nine CNGOF members answered to the survey. They were 69% to declare performing less than 10% of episiotomy in case of spontaneous vertex delivery. The most frequent systematic indication of episiotomy was the personal history of obstetric anal sphincter injury (more than 30% of answerers). Systematic episiotomy was less frequent in case of vacuum assisted operative delivery compared to forceps (OR=0.18 [0.08-0.37]) or spatulas (OR=0.28 [0.12-0.59]). Most of practitioners (94%) declared performing mediolateral episiotomies, 64% declared cutting with an equal or more than 45° angle and 50% declared using a resorbable continuous suture technique for the reparation. Half of the answerers (46%) indicated that they inform et collected women's consent before performing an episiotomy.

Conclusions: Several practices, women's information, section angle and the reparation technique are subject to change by the latest 2018 CNGOF guidelines about perineal protection.

Keywords: Accouchement; Accouchement instrumental; Delivery; Episiotomy; Lésion obstétricale du sphincter anal; Obstetric anal sphincter injury; Operative delivery; Épisiotomie.