Episiotomi Rutin VS Episiotomi Selektif pada Persalinan Pervaginam

Oleh :

dr. Cipta Pramana SpOGK

Masih ada perdebatan mengenai apakah lebih baik episiotomi dilakukan secara selektif atau rutin pada ibu yang menjalani persalinan pervaginam. Episiotomi merupakan tindakan kebidanan yang dilakukan untuk memperbesar diameter jalan lahir, vagina, atau vulva untuk mempermudah lewatnya kepala janin, serta untuk mencegah robekan perineum yang luas saat berlangsungnya proses persalinan.[1-3]

Prosedur episiotomi pertama kali diperkenalkan oleh Ould pada tahun 1741, yang kemudian dianjurkan untuk dilakukan pada semua persalinan primipara untuk melindungi ibu dari trauma dasar panggul dan laserasi perineum yang tidak terkendali. Namun, pada tahun 1920, Joseph DeLee, seorang dokter spesialis kebidanan dan kandungan terkenal dari Chicago, merekomendasikan penggunaan episiotomi secara selektif atau hanya jika ada indikasi ibu atau janin saja.[1-4]

Bukti Ilmiah: Episiotomi Rutin vs Selektif

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Pebolo PF, Judith A, Dan KK. Episiotomy related morbidities measured using redness, edema, ecchymosis, discharge and apposition scale and numerical pain scale among primiparous women in mulago national referral hospital, kampala, uganda. Pan Afr Med J. 2020;36(347):1–12.
2. Salim S, P DB, Balakrishnan D. Comparative evaluation of maternal outcome in Primigravida delivery with routine episiotomy and with selective episiotomy: A hospital based prospective study. Int J Clin Obstet Gynaecol. 2020;4(5):296–8.
3. Corrêa Junior M, Passini Júnior R. Selective Episiotomy: Indications, Technique, and Association with Severe Perineal Lacerations. Rev Bras Ginecol e Obs / RBGO Gynecol Obstet. 2016;38(06):301–7.
4. Serati M, Salvatore S, Rizk D. Episiotomy in modern clinical practice: friend or foe? Int Urogynecol J. 2019;669–71.
5. Venus D, Rao P, Prajwal S. Comparison of use of restrictive episiotomy versus routine episiotomy in primigravidae undergoing vaginal birth at a tertiary care hospital. Int J Repro Contracept Obst Gyn, 2017. 6(5): 1770-76. doi:http://dx.doi.org/10.18203/2320-1770.ijrcog20171501.
6. Sangkomkamhang U, Kongwattanakul K, Kietpeerakool C, Thinkhamrop J, Wannasiri P, Khunpradit S, et al. Restrictive versus routine episiotomy among Southeast Asian term pregnancies: a multicentre randomised controlled trial. BJOG An Int J Obstet Gynaecol. 2020;127(3):397–403.
7. Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017 Feb 8;2(2):CD000081. doi: 10.1002/14651858.CD000081.pub3. PMID: 28176333; PMCID: PMC5449575.
8. Sultan AH, Thakar R, Ismail KM, Kalis V, Laine K, Räisänen SH, et al. The role of mediolateral episiotomy during operative vaginal delivery. Eur J Obstet Gynecol Reprod Biol. 2019;240:192–6.
9. WHO. WHO recommendations: intrapartum care for a positive childbirth experience. 2018. https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en/
10. Nasr AM. Research Article Controversial Benefit Of Episiotomy On Maternal And Fetal Outcomes A Prospective Comparative Clinical Study. Int J Curr Res, 2019. DOI: https://doi.org/10.24941/ijcr.37609.09.2019
11. Modi DA, Vaishnav PP. Routine versus selective use of episiotomy in primigravida: a prospective non-randomized case-control study. Int J Reprod Contraception, Obstet Gynecol. 2020;9(3):1003.
12. Pebolo F, Judith A, Kabonge Dan K. Prevalence and factors associated with episiotomy practice among primiparous women in mulago national referral hospital Uganda. Int J Pregnancy Child Birth. 2019;5(5):197–201.
13. Tefera T, Kebede B, Mekonen T. Prevalence of Episiotomy and Factors Associated With Practice of Episiotomy At Saint Paul ’ S Hospital Millennium Medical College : a Cross Sectional Study Abstract Introduction : Ethiop J Reprod Heal. 2019;11(3):33–40.