Clinical Effects of Postero-Lateral Episiotomy in Natural Childbirth on Maternal and Neonatal Outcomes

Abstract

Objective To investigate the maternal and neonatal outcomes of postero-lateral episiotomy in natural childbirth of low-risk primipara women. Methods Clinical data of 1 000 cases of low-risk primipara women with head position, singleton who were selected from First Affiliated Hospital of Third Military Medical University between May 2012 to May 2013 were analyzed. They were divided into episiotomy group (n = 500) and non-episiotomy group (n = 500) according to receiving postero-lateral episiotomy or not. There had no significant differences on age and gestational age between two groups (P> 0.05). The following items were compared: duration of the second stage of labor, amount of bleeding during labor, incidence of perineal laceration, neonatal 1 min and 5 min Apgar score, incidence rate of neonatal asphyxia at 1 min and 5 min after birth between two groups. The study protocol was approved by the Ethical Review Board of Investigation of First Affiliated Hospital of Third Military Medical University. Informed consent was obtained from all participates. Results The amount of bleeding during labor in episiotomy group was significantly more than that in non-episiotomy group [(366.73±44.43) mL vs. (287.33±19.08) mL] (t=3.707,P=0.001). But there were no significant differences in the duration of the second stage of labor, incidence of perineal laceration, neonatal 1 min and 5 min Apgar score and incidence rates of neonatal asphyxia at 1 min and 5 min after birth between two groups (t=1.773, P = 0.083; χ2 = 3.824, P = 0.373;t=0.330, P = 0.751; t=1.580, P = 0.157;χ2 =0.028, P = 0.799;χ2 = 2.318, P=0.453). Conclusions Maternal and neonatal outcomes in episiotomy group were not superior to those in non-episiotomy group, so routine postero-lateral episiotomy should not be advocated in natural childbirth for low-risk primipara women conventionally. Key words: Parity; Natural childbirth; Episiotomy; Labor stage, second; Pregnancy outcome