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  • Title: The Philadelphia Episiotomy Intervention Study.
    Author: Goldberg J, Purfield P, Roberts N, Lupinacci P, Fagan M, Hyslop T.
    Journal: J Reprod Med; 2006 Aug; 51(8):603-9. PubMed ID: 16967628.
    Abstract:
    OBJECTIVE: To lower the episiotomy rate through physician education and documentation of indication when episiotomy was performed. STUDY DESIGN: The intervention consisted of an evidence-based lecture recommending limited usage of episiotomy and requesting documentation of any episiotomy's indication. Data 3 months prior to the intervention were compared to those of the year following. Adjusted comparisons of episiotomy rates were completed using multivariate logistic regression models. RESULTS: For all vaginal deliveries, there was a 17% decrease in the rate of episiotomy, from 46.9% to 38.8%. For spontaneous vaginal deliveries, there was a 25% decrease in the episiotomy rate, from 40.8% to 30.8%. The most common indications for episiotomy reported were routine/elective, 41.0%; vacuum, 18.6%; forceps, 16.4%; and nonreassuring fetal heart tracing, 10.9%. CONCLUSION: Episiotomy rates may be effectively reduced through physician education and documentation of procedure indication.
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