Episiotomy

Homsi, Riad; Daikoku, Norman H.; Littlejohn, John; Wheeless, Clifford R.

doi:10.1097/00006254-199412000-00002

Cited by 68 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Episiotomy may result in extension of the episiotomy incision and deformed anatomic outcomes, increased blood loss and hematoma formation, discomfort and pain, inflammation, infection and dehiscence within the episiotomy region, sexual dysfunction, and increased costs. It is unclear whether routine episiotomy improves the long-term risks of pelvic floor relaxation, pelvic organ prolapse, urinary incontinence, and dyspareunia [5, 6]. Moreover, mediolateral episiotomy found to be an independent risk factor for the third or fourth degree perineal tears even in critical conditions such as shoulder dystocia, instrumental deliveries, occiput-posterior position, fetal macrosomia, and non-reassuring fetal heart rate [1, 7].…”

Section: Introductionmentioning

confidence: 99%

Once episiotomy, always episiotomy?

Zilberman

Barrett

Hamou

et al. 2018

Arch Gynecol Obstet

View full text Add to dashboard Cite

ObjectiveTo investigate the association between episiotomy and perineal damage in the subsequent delivery.Study designA retrospective cohort study was conducted, comparing outcome of subsequent singleton deliveries of women with and without episiotomy in their first (index) delivery. Deliveries occurred between the years 1991–2015 in a tertiary medical center. Traumatic vaginal tears, multiple pregnancies, and cesarean deliveries (CD) in the index pregnancy were excluded from the analysis. Multiple logistic regression models were used to control for confounders.ResultsDuring the study period, 43,066 women met the inclusion criteria; of them, 50.4% (n = 21,711) had subsequent delivery after episiotomy and 49.6% (n = 21,355) had subsequent delivery without episiotomy in the index pregnancy. Patients with episiotomy in the index birth higher rates of subsequent episiotomy (17.5 vs. 3.1%; P < 0.001; OR 1.9; 95% CI). In addition, the rates of the first and second degree perineal tears as well as the third and fourth degree perineal tears were significantly higher in patients following episiotomy (33.6 vs. 17.8%; P < 0.001, and 0.2 vs. 0.1%; P = 0.002, respectively). Nevertheless, there was no significant difference at the rates of CD and instrumental deliveries, between the groups. While adjusting for maternal age, ethnicity, birth weight, and vacuum delivery—the previous episiotomy was noted as an independent risk factor for recurrent episiotomy in the subsequent delivery (adjusted OR 6.7; 95% CI 6.2–7.3, P < 0.001). The results remained significant for term (adjusted OR 6.8; 95% CI 6.2–7.4, P < 0.001) as well as preterm deliveries (adjusted OR 4.5; 95% CI 3.3–6.3, P < 0.001) in two different models.ConclusionEpisiotomy is an independent risk factor for recurrent episiotomy in the subsequent delivery.

show abstract

Section: Introductionmentioning

confidence: 99%

Once episiotomy, always episiotomy?

Zilberman

Barrett

Hamou

et al. 2018

Arch Gynecol Obstet

View full text Add to dashboard Cite

show abstract

Section: Epidemiologymentioning

confidence: 99%

“…The total number of cases corresponds to 0.1% of all vaginal births [6]. Rectovaginal fistula occurs in 0.2–2.1% of patients with chronic inflammatory bowel disease (particularly Crohn's disease) [1], and following low anterior rectal resection, the frequency is as high as 10% [6], [7], [8], [9], [10]. In recent years, rectovaginal fistula has been an increasingly common complication following hemorrhoid or pelvic floor surgery, particularly in cases where staplers or foreign materials were used [11], [12], [13], [14], [15], [16].…”

Section: Epidemiologymentioning

confidence: 99%

German S3-Guideline: Rectovaginal fistula

Ommer¹,

Herold²,

Berg³

et al. 2012

GMS German Medical Science; 10:Doc15; ISSN 1612-3174

View full text Add to dashboard Cite

“…When tied, the knots are on the top of the overlapped sphincter ends. Care must be taken to incorporate the muscle capsule in the closure [15][16][17].…”

Section: Surgical Techniques For Repairing Third Degree Perineal Tearmentioning

confidence: 99%

Third degree perineal lacerations-How, why and when? A review analysis

Daniilidis¹,

Markis²,

Tzafetas³

et al. 2012

OJOG

View full text Add to dashboard Cite

Aim: The aim of this article is to present the knowledge of current literature regarding epidemiology and predisposing factors, classification and surgical treatment of third degree perineal tears. Materials and Methods: We reviewed current articles in English language from medline and Pub-Med using as key words “vaginal repair, third degree tear, episiotomy and vaginal delivery”. We summarized literature regarding predisposing factors, epidemiology, prevention and surgical treatment of third degree perineal tears. Results: it is demonstrated today by several studies that widespread episiotomy is responsible for the increasing frequency of 3rd degree lace-rations of the perineum which are significantly associated with forceps and the use of gynecological chair (boom) for vaginal delivery. Primiparous women with babies weighting >4 kgr, are at greater risk. Two types of surgical repair: end-to-end approximation and overlapping of torn ends of the anal sphincter, are both related to the functional outcome of the repair. Conclusion: Episiotomy is an important risk factor for severe lacerations after vaginal delivery. Midline episiotomy and assisted vaginal delivery should be avoided whenever possible, especially in the presence of a large baby. Recent evidence suggests that there is no significant advantage between overlap repair and approximation technique, with regard to fecal incontinence

show abstract

Episiotomy

Cited by 68 publications

References 0 publications

Once episiotomy, always episiotomy?

Once episiotomy, always episiotomy?

German S3-Guideline: Rectovaginal fistula

Third degree perineal lacerations-How, why and when? A review analysis

Contact Info

Product

Resources

About