Abstract
SummaryTwo hundred primigravid women delivered vaginally were allocated at random to one of two groups. Patients in one group were to undergo episiotomy unless it was considered unnecessary (elective). Those in the other group were not to undergo episiotomy unless it was considered to be essential (selective). The resultant episiotomy rates were 83 and 53 per cent respectively. An intact perineum was more common among those allocated not to undergo routine episiotomy but these patients had more second degree perineal lacerations (8 per cent). No difference was found between the two groups in either paraurethral lacerations or lateral vaginal wall lacerations. We favour selective use of episiotomy in primigravid patients.
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