DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160604

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

Jyoti Malik, Sibadatta Das, Ashima Das, Pinki Rai

Abstract


Background: Episiotomy is the most commonly performed surgical procedures during delivery; but there is extensive disagreement about the necessity and benefits of this procedure. This study is an effort to compare the outcome of routine versus restricted use of episiotomy in tertiary care center.

Methods: A prospective observational study was conducted for singleton normal vaginal term deliveries. Deliveries managed with routine use of episiotomy formed the ‘control group’, while those managed with restricted use of episiotomy formed the ‘study group’. Data so obtained was analyzed.

Results: Total no of deliveries analyzed were 458 (210 control group+248 study group). Restricted use of episiotomy led to 64% (n=159) women delivering without any perineal lacerations in ‘study group’. This translated into 41% (n=38) reduction in no of perineal lacerations in primipara, and 23% (n=36) in multipara, compared to the ‘control group’. Only 2% of primipara in ‘study group’ had severe 3rd degree perineal tears.

Conclusions: Restricted use of episiotomy resulted in considerable reduction in maternal morbidity due to perineal lacerations.

Keywords


Episiotomy, Perineal lacerations, Perineal tears, Restricted use, Routine

Full Text:

PDF

References


Low LK, Senge JS, and Murtland TL. Clinician Specific episiotomy rates: impact on perineal outcomes, J Midwifery women’s Health. 2000;45:87-93.

Hartmann K, Viswanathan M, Palmier R. Outcomes of routine episiotomy: a systematic review. JAMA. 2005;293:21:41-8.

American college of Obstetricians and Gynecologists. Episiotomy. ACOG Practice Bulletin no 71. Obstet Gynaecol. 2006;107:957-62.

Sartore A, De Seta F, Maso G. The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery. Obstet Gynaecol. 2004;103:669-73.

Bhatia JC, Cleland J. determinants of maternal care in region of South India, Health Transition. 1995:127-42.

Macarthur AJ, Macarthur C. Incidence, severity and determinants of perineal pain after vaginal delivery: aprospective cohort study. Am J Obstet Gynaeccol. 2004;191:1199-204.

Signorello LB, Harlow BL, Chekos AK. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of Primiparous women. Am J Obstet Gynaecol. 2001;184:881-90.

Anthony S, Buitendijk SE, Zondervan KT, Van Rijssel EJ, Verkerk Ph. Episiotomies and the occurrence of severe perineal lacerations. Br J obstet Gynaecol. 1994;101:1064-7.