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[Episiotomy: clinical, technical and psychological aspects]

P Visco1, A Tocca, P L Russo

  • 1I Clinica Ostetrica e Ginecologca, Università degli Studi di Roma, La Sapienza, Roma.

Minerva Ginecologica
|January 1, 1996
PubMed
Summary

Selective episiotomy does not prevent fetal neurological damage but may increase severe perineal lacerations. It also carries risks of postpartum sexual dysfunction, questioning its routine use.

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Area of Science:

  • Obstetrics and Gynecology
  • Perineal Trauma
  • Fetal Health

Context:

  • Investigating the clinical utility of selective episiotomy versus routine use.
  • Examining conflicting evidence on episiotomy's role in preventing perineal lacerations.
  • Assessing episiotomy's impact on fetal outcomes and maternal sexual health.

Purpose:

  • To evaluate the effectiveness and safety of selective episiotomy utilization.
  • To analyze the association between episiotomy and perineal laceration severity.
  • To determine episiotomy's influence on fetal neurological status and maternal sexual function.

Summary:

  • Retrospective data suggest episiotomy may protect against minor lacerations but predispose to severe ones.
  • No significant difference in Apgar scores or mortality rates was observed in newborns with or without episiotomy.

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  • Episiotomy is linked to complications like dyspareunia and sexual dysfunction post-delivery.

    • Impact:

    • Findings challenge the routine use of episiotomy, highlighting potential risks over benefits.
    • Provides evidence for informed decision-making regarding episiotomy in obstetric practice.
    • Emphasizes the need for further research into alternative methods for perineal protection.