Related Experiment Videos
[Episiotomy--an appeal for a more restricted use]
1Kvinneklinikken, Haukeland Sykehus, Bergen.
Summary
Episiotomy, a common surgical procedure, may increase the risk of anal sphincter rupture, contrary to popular belief. Selective use of episiotomy is recommended to reduce severe perineal trauma.
Area of Science:
- Obstetrics and Gynecology
- Surgical Procedures
Background:
- Episiotomy is a frequently performed surgical procedure during childbirth, with rates often ranging from 50-90%.
- Presumed benefits include preventing perineal lacerations, particularly anal sphincter rupture, and protecting the fetal head.
Purpose of the Study:
- To evaluate the evidence supporting the benefits of episiotomy.
- To assess the association between episiotomy rates and maternal morbidity, specifically anal sphincter rupture.
Main Methods:
- Review and analysis of three randomized studies on episiotomy.
- Examination of existing literature on episiotomy practices and outcomes.
Main Results:
- Limited evidence supports the presumed benefits of episiotomy.
- High episiotomy rates are linked to an increased risk of anal sphincter rupture.
- Long-term morbidity associated with sphincter rupture is significant.
Conclusions:
- A more selective approach to episiotomy is warranted.
- Recommended episiotomy rates should be reduced to 20-30%.
- Indications for episiotomy should be restricted, primarily to instrumental deliveries like forceps or ventouse.