Routine versus selective use of episiotomy in primigravida: a prospective non-randomized case-control study

Authors

  • Dipti A. Modi Department of Obstetrics and Gynecology, Baroda Medical College, Vadodara, Gujarat, India
  • Palak P. Vaishnav Department of Obstetrics and Gynecology, Baroda Medical College, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20200864

Keywords:

Episiotomy, Perineal pain, Perineal tear, Routine, Selective use

Abstract

Background: Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labour. It is an inflicted second-degree perineal tear. Objective of this study was to determine the possible benefits and risks of the use of selective episiotomy versus routine episiotomy during delivery in primigravida.

Methods: This is a prospective non-randomized case-control study designed to analyze and compare the maternal outcomes following routine versus selective use of episiotomy in primigravida. In control group, 122 patients were recruited and mediolateral episiotomy was given in all patients; while in study group, 61 patients were recruited, in whom episiotomy was given selectively.

Results: In study group 61 patients were recruited, out of which episiotomy can be avoided in 23 (37.7%) of cases. There was no 3rd or 4th degree perineal tear found in any group. Perineal pain score on 3rd day postpartum was less in study group, as compared to control group on bed rest, sitting, walking and defecation.

Conclusions: Selective use of episiotomy can improve maternal outcome by reducing perineal lacerations and those having intact perineum can have the best outcome when episiotomy is given selectively.

References

Dutta DC, Konar H. DC Dutta’s textbook of obstetrics including perinatology and contraception. New Delhi, India: Jaypee, The Health Sciences Publisher; 2013:568.

Hale R, Ling F. Episiotomy: procedure and repair techniques. Am College Obstet Gynecol. 2007;4. Available at: https://www.scribd.com/doc/285746166/Episiotomy-ACOG. Accessed on 3rd January 2020.

Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017;(2):8.

Clemens D. ACOG: New Recommendations on Obstetric Lacerations. 2016. Available at: https://anesthesiaexperts.com/uncategorized/acog-recommendations-obstetric-lacerations. Accessed on 3rd January 2020.

Saxena R, Sandhu G, Babu K, Bandol H, Sharma G. Restricted use of episiotomy. The J Obstet Gynecol India. 2010;60(5):408-12.

Ali SS, Malik M, Iqbal J, Faruqi NJ. Routine episiotomy versus selective episiotomyin primigravidae. Annals King Edward Med Univer. 2014;10:4.

Eltorkey MM, Nuaim MA. Episiotomy, elective or selective: a report of a random allocation trial. J Obstet Gynaecol. 1994;14(5):317-20.

Harrison RF, Brennan M, North PM, Reed JV, Wickham EA. Is routine episiotomy necessary?. Br Med J (Clin Res Ed). 1984;288(6435):1971-5.

Juste-Pina A, Luque-Carro R, Sabeter-Adan B, Miguel E, Vinerta-Serrano E, Cruz-Guerreio E. Selective episiotomy versus routine episiotomy in nulliparous women with vaginal delivery performed by midwives. Matronas Profession. 2007;8:5-11.

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Published

2020-02-27

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Original Research Articles