[Episiotomy : what are its indications in the era of restrictive use ?]

Episiotomy was traditionally performed routinely during vaginal delivery to prevent severe obstetric anal sphincter injuries and to shorten the second stage of labor, with the aim of improving neonatal outcomes. However, accumulating evidence has challenged these benefits. Its adverse consequences, including hemorrhagic, urinary, and infectious complications, as well as dyspareunia and psychological disorders, have prompted scientific societies to recommend a restrictive policy. Despite this consensus, clinical practices remain heterogeneous, and the potential role of episiotomy in specific situations is still being debated. This review examines the current place of episiotomy in light of recent evidence and international guidelines.