Perineal injuries during childbirth, especially severe perineal injuries, can lead to
adverse health outcomes for women both in the short and longer term and can
significantly affect women´s quality of life. The use of epidural analgesia during
childbirth, instrumental deliveries and primiparity are some of the predisposing
factors associated with severe perineal injuries. In Catalonia there is an upward
trend in the use of epidural analgesia in recent years, but its effect in healthy
women is unknown.
The ...
Perineal injuries during childbirth, especially severe perineal injuries, can lead to
adverse health outcomes for women both in the short and longer term and can
significantly affect women´s quality of life. The use of epidural analgesia during
childbirth, instrumental deliveries and primiparity are some of the predisposing
factors associated with severe perineal injuries. In Catalonia there is an upward
trend in the use of epidural analgesia in recent years, but its effect in healthy
women is unknown.
The type of birth and obstetric interventions women receive during labor are
considered an important indicator of women's quality of life and these figures
become an indispensable tool to plan and develop health policy.
Despite its importance, there is no data on the effect of the use of epidural
analgesia on severe perineal injuries and its effect on other obstetric outcomes,
which makes it impossible to implement actions in this area.
The main objective of the study is to obtain data regarding the use of epidural
analgesia during childbirth in relation to severe perineal injuries and other
obstetric outcomes in order to guide the implementation of policies aimed at
improving perinatal outcomes. The specific objectives are to identify these results
within our region based on data is generated from the MidconBirth study; to
ascertain the effects of exposure time to EA in relation to instrumental deliveries;
and finally, to devise a clinical trial protocol to test a digital tool for the use of
heath care professionals and test whether it helps improve the management of
normal birth care.
This study concludes in three main results: a) provides, for the first time, data on
the relationship of the use of epidural with severe perineal injuries during labor in
our region; b) it shows a direct relationship between the time of exposure to
epidural and birth mode; c) childbirth care offered in our region indicates that the
Clinical Practice Guide for normal birth care is not properly implemented d) with
the A-BIRTHPERFORM tool, compliance with clinical guidelines could be
improved thus contributing to the improvement of perinatal outcomes and
maternal satisfaction.
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Programa de doctorat en Biomedicina
