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|Title:||Influence of training in the use and generation of evidence on episiotomy practice and perineal trauma|
|Citation:||International Journal of Gynecology & Obstetrics, 2010; 111(1):13-18|
|Publisher:||Elsevier Sci Ireland Ltd|
|Jacqueline J. Ho, Porjai Pattanittum, Robert P. Japaraj, Tari Turner, Ussanee Swadpanich, Caroline A. Crowther, for the SEA-ORCHID Study Group|
|Abstract:||<h4>Objective</h4>To examine episiotomy practices before and after a multi-component intervention designed to support the use and generation of research evidence in maternal and neonatal health care.<h4>Methods</h4>Set in 9 centers across 4 Southeast Asian countries, a retrospective survey was performed for 12 recommended pregnancy/childbirth practices and 13 outcomes of women in each center before and after intervention. Qualitative interviews were conducted to assess staff awareness and experience in evidence-based practice.<h4>Results</h4>There were significant decreases in the rate of episiotomy, from 64.1% to 60.1% (risk difference [RD] -4.0; 95% confidence interval [CI], -5.8 to -2.2) for all women and from 92.2% to 80.7% (RD -11.5; 95% CI, -13.4 to -9.6) for nulliparous women. Severe trauma decreased from 3.9% to 1.9% (RD -2.0; 95% CI, -2.7 to -1.4) for all women and from 6.7% to 3.0% (RD -3.7; 95% CI, -4.9 to -2.5) for nulliparous women. The frequency of intact perineum increased from 12.4% to 15.6% (RD 3.2; 95% CI, 1.9-4.6) for all women and from 1.7% to 8.0% (RD 6.3; 95% CI, 5.0-7.5) for nulliparous women.<h4>Conclusion</h4>An intervention based on understanding and using the best available evidence can result in significant improvements in care and health outcomes.|
|Keywords:||Capacity building; Episiotomy; Low-income countries; Practice change|
|Rights:||Crown Copyright © 2010 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. All rights reserved.|
|Appears in Collections:||Obstetrics and Gynaecology publications|
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