Episiotomy Group Research Articles

Comparison between different perineal outcomes on tissue healing

Perineal healing was compared between 181 women with episiotomies and 186 women without episiotomies at one to two weeks after delivery. Subjects were medically indigent low-risk women who had normal spontaneous vaginal deliveries at the same tertiary-care hospital. Maternal age, race, parity, and birth weight did not have an independent effect on perineal healing. Perineal outcome at delivery and length of second stage exhibited a significant relationship with perineal healing. Overall, there was a 4.9% incidence of delayed perineal healing due to wound separation or clinical infection. In the episiotomy group, 7.7% of the subjects experienced delayed perineal healing compared with 2.2% in the no-episiotomy group. This was statistically significant using Pearson chi-square analysis. These results suggest that women without episiotomies exhibit better perineal healing than women with episiotomies.

Advantage or Disadvantage of Episiotomy Compared with Spontaneous Perineal Laceration

In a prospective clinical investigation of 2,144 deliveries, we elucidate the indications for episiotomy and how different methods of anesthesia affect the frequency of episiotomy and the perineal problems after episiotomy compared with those after spontaneous perineal laceration. We found a significantly higher infection rate (p less than 0.001) and a longer healing period in the episiotomy group. These differences remain even if only primigravida or the indication, imminent perineal laceration, is studied. The results indicate that many women will unnecessarily suffer after an episiotomy. The patient's subjective problems are significantly increased, both immediately and at the 3-month postoperative follow-up.

Episiotomy and perineal trauma during childbirth.

A study was conducted to assess the frequency of episiotomy and spontaneous tears in 807 primiparas during singleton births. The incidence of episiotomy was 50%, spontaneous tears 22% and intact perineum 28%. A significantly lower frequency of episiotomy (P less than 0.001) as well as epidural anaesthesia (P less than 0.001) was found among immigrant women. There were no indications registered for 58% of the episiotomies. The non-episiotomy group experienced more clitoris/labia tears (P less than 0.01). On the other hand there was a tendency towards an increased risk for second and third degree tears, 4.2% in the episiotomy group compared to 1.7% in the non-episiotomy group (P = 0.06). Haemorrhage (greater than 600 ml) was more frequent in the episiotomy group than in the non-episiotomy group (P less than 0.001). We conclude that there is little support for the claim that episiotomy prevents tears in normal deliveries, and that the rationale for the practice of episiotomy is in need of reappraisal.

Evaluation of Episiotomy and Spontaneous Tears of Perineum during Childbirth

ABSTRACT. While episiotomy is a common operation during delivery little is known of its benefits compared with spontaneous tears. This study was designed to evaluate and compare episiotomies and spontaneous tears. The sample comprised 205 primiparas, 157 with episiotomies and 48 with spontaneous tears. Women with episiotomies expressed more discomfort, perineal complications were more pronounced and prolonged, and fewer were able to participate in the post‐partum exercises. Furthermore, delayed healing was recorded for the episiotomy group and more analgesia was used post‐partum by women with episiotomies.

Intact perineum: A slow delivery of the head does not adversely affect the outcome of the newborn

Apgar scores at 1 and 5 min were compared in a retrospective study of two groups of primipara women in order to determine if a slow delivery of the head over an intact perineum compromises the well being of the newborn. Since the intact perineum group did not demonstrate significantly lower scores at either 1 or 5 min, it may be concluded that newborn well being is not compromised by a slow delivery of the head over an intact perineum. The statistical difference at 1 min was contributed to largely by the greater number of Apgar scores of 9 (49%) in the intact perineum group and the greater number of Apgar scores of 8 (44%) in the median episiotomy group. These higher scores in the newborns from the intact perineum group certainly support the need for additional study as well as raise significant questions concerning aspects of the rationale for the routine use of episiotomy in North American obstetrics.