Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Trials

Background:

• Routine episiotomy is contraindicated, yet its necessity in any circumstance remains unproven.
• Evidence supports selective use, but optimal protocols require further investigation.

Purpose of the Study:

• To compare maternal and perinatal outcomes between a non-episiotomy protocol and a selective episiotomy protocol.
• To evaluate the safety and efficacy of avoiding episiotomy during childbirth.

Main Methods:

• An open-label, randomized clinical trial involving 241 women in labor.
• Participants were assigned to either a non-episiotomy protocol or a selective episiotomy group.
• Maternal and perinatal outcomes were assessed, with risk ratios and confidence intervals calculated.

Main Results:

• No significant differences in maternal or perinatal outcomes were observed between the groups.
• Episiotomy rates were low and similar in both protocols (approximately 1.7%).
• Key metrics like labor duration, perineal trauma, and blood loss showed no variation.

Conclusions:

• A non-episiotomy protocol demonstrates safety for both mother and child.
• The findings underscore the need to re-evaluate any established indications for episiotomy.