Episiotomy and Increase in the Risk of Obstetric Laceration in a Subsequent Vaginal Delivery

Risk of Episiotomy and Perineal Lacerations Recurring After First Delivery

“…Also, observations from the West Berkshire randomized perineal management trial suggest an association between perineal damage or episiotomy at the first delivery and the same kind of lesion at the following ones, even though the results were not statistically significant. In that study, two groups were made as follows: “the liberal group” (episiotomy made to prevent tears) and “the restricted group” (episiotomy made just in case of fetal indications).…”

Prevalência e fatores associados à prática da episiotomia em maternidade escola do Recife, Pernambuco, Brasil

“…19 Episiotomy performance in the first birth is a risk factor for the occurrence of spontaneous lacerations in subsequent births, as stated in a U.S. study (OR 4.47; CI95% 3.78-5.30), including third and fourth degree perineal lesions (OR 5.25; CI95% 2.96-9.32). 25 In our study it was not possible to assess episiotomy occurrence in previous births, due to the non-existence of registrations of this datum in the medical files. Yet, the frequency of lacerations was significantly higher in patients without episiotomy, mainly anterior perineum and furcula lesions.…”

Risk factors for episiotomy during vaginal childbirth: A retrospective cohort study in Western China

“…Since 1995, the World Health Organization (WHO) has developed guidelines to limit the routine episiotomy, stating that only fetal distress is recommended as an indication for episiotomy in obstetric and midwifery guidelines . Complications associated with episiotomy include negative birth experience, unsatisfactory anatomic results, increased postpartum blood loss and pain, discomfort of the wound and sutures, higher rates of infection and dehiscence, urinary incontinence, sexual dysfunction, and possible increased risk of perineal lacerations in subsequent deliveries . Restrictive episiotomy (“only if needed”) is significantly beneficial for women over a routine approach (“part of routine management”).…”