Risk factors for mediolateral episiotomy at a tertiary hospital: a cross-sectional study

SUMMARY OBJECTIVE: The main aim of this study was to assess the associated factors for selective mediolateral episiotomy at a tertiary, academic hospital. METHODS: A retrospective cohort analysis between 2017 and 2019 was performed. The primary outcome was the prevalence of selective mediolateral episiotomy. Independent variables were maternal, intrapartum, and neonatal characteristics. A significance level of 5% was established, and univariate and multivariate analyses with logistic regression models were performed. RESULTS: From 2,761 vaginal deliveries eligible for inclusion during this period, the prevalence of selective mediolateral episiotomy was 18.7%. Univariate analysis has shown that non-white women were protective factors (OR=0.77 [0.63-0.96]; p=0.02) for episiotomy; primiparity (OR=2.61 [2.12-3.21]; p<0.01), number of vaginal examinations between 6-10 repetitions (OR=3.16 [2.48-4.01]; p<0.01) and 11-20 repetitions (OR=5.40 [3.69-7.90]; p<0.01), longer second stage duration (OR=1.01 [1.00-1.02]; p<0.01), and women with gestational age more than 37 weeks were risk factors. Multivariate analysis reported that second stage duration (AOR=1.01 [1.00-1.03]; p<0.01), primiparity (AOR=2.03 [1.34-3.06]; p<0.01), and number of vaginal examinations between 6-10 repetitions (AOR=2.36 [1.50-3.70]; p<0.01) and 11-20 repetitions (AOR=3.29 [1.74-6.20]; p<0.01) were remained as risk factors for selective mediolateral episiotomy. CONCLUSION: A higher number of vaginal examinations during labor (over six repetitions), longer duration of second stage labor, and primiparity were risk factors associated with selective mediolateral episiotomy.

Existia questão social na experiência soviética? / Was there social question in soviet experience?

Resumo: A "questão social" está associada ao sistema capitalista. Mas as contradições sociais do sistema soviético tornam o debate sobre a "questão social" mais complexo, uma vez que tal experiência revolucionária destruiu o capitalismo, mas manteve a essência da natureza do sistema do capital, segundo István Mészáros. O artigo pretende contribuir para a reflexão: a "questão social" existe apenas no sistema capitalista ou também existia, por meio de expressões distintas, na experiência soviética?

Abstract: "Social question" is associated with capitalism system. However, the social contradictions of soviet system turn the debate about "social question" more complex. Since this revolutionary experience overthrew capitalism, but preserved the essence of the capital's system's nature, according to István Mészáros. The article intends to contribute for the reflection: exists the "social question" only in capitalism system or also was there in soviet experience, through distincts expressions?