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Episiotomy and third-degree tears.

P Buekens, R Lagasse, M Dramaix

    British Journal of Obstetrics and Gynaecology
    |August 1, 1985
    PubMed
    Summary
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    Episiotomy use was initially linked to higher rates of third-degree perineal tears. However, after adjusting for confounding factors in a subgroup analysis, no significant relationship was found between episiotomy and severe perineal tears.

    Area of Science:

    • Obstetrics and Gynecology
    • Perineal Trauma Research

    Background:

    • Episiotomy is a surgical procedure during childbirth.
    • Third-degree perineal tears are severe obstetric injuries.

    Purpose of the Study:

    • To investigate the relationship between episiotomy and third-degree perineal tears.
    • To determine if episiotomy increases the risk of severe perineal lacerations.

    Main Methods:

    • Retrospective analysis of 21,278 singleton deliveries.
    • Comparison of third-degree tear incidence in deliveries with and without episiotomy.
    • Subgroup analysis of vertex presentations with spontaneous occipitoanterior vaginal deliveries, stratified by birthweight and parity.

    Main Results:

    • Initial analysis showed a higher incidence of third-degree tears with episiotomy (1.4%) versus without (0.9%) (P < 0.01).

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  • After controlling for confounding factors in a selected subgroup, no significant association between episiotomy and third-degree tears was observed.

    • Conclusions:

    • The initial association between episiotomy and third-degree tears may be confounded by other factors.
    • In carefully selected spontaneous vaginal deliveries, episiotomy does not appear to increase the risk of severe perineal tears.