Episiotomies and the occurrence of severe perineal lacerations

Abstract

Objective To investigate the relation between the use of mediolateral episiotomy and the Design An observational study. Subjects Data were derived from the Dutch National Obstetric Database (LVR) of 1990, from which 43 309 spontaneous, occipito-anterior, vaginal deliveries of live, singleton infants were investigated.occurrence of severe (third degree) perineal tears in hospital deliveries in the Netherlands.Intervention Medio-lateral episiotomy.Main outcome measure The occurrence of severe perineal tears.197 1 -1975. 587-590.

Judicial use of episiotomy in singleton normal vaginal deliveries at term: the changing trend

“…Another significant conclusion was that a higher Episiotomy rate was not associated with lower tear rate. 8 Results of this study also indicate that women who deliver neonates weighing more than 3.5 kg were at an increased risk of receiving Episiotomy.…”

Restricted use of episiotomy

“…In primiparas 48 episiotomies and in multiparous women 106 episiotomies would have to be performed to prevent one severe perineal tear. Another significant conclusion was that a higher episiotomy rate was not associated with a lower tear rate 8 .…”

Anal Sphincter Injury After Forceps Delivery: Myth or Reality?

“…Posterolateral episiotomies are usually performed to prevent uncontrolled perineal lacerations at the time of vaginal delivery, 54 but the benefits of this procedure have been questioned, and many authors have claimed that routine use of posterolateral episiotomy may contribute to anal sphincter injury. 7,11,19,20,55,56 As a result, the current trend is toward restricting the use of episiotomy to certain necessary indications, such as malpresentation, shoulder dystocia, persistent occipito-posterior position, fetal distress, or forceps delivery. 57,58 We found no isolated defect of the IAS.…”