Related Experiment Videos
Is routine use of episiotomy justified?
R L Lede1, J M Belizán, G Carroli
1Centro Rosarino de Estudios Perinatales, Argentina.
American Journal of Obstetrics and Gynecology
|May 1, 1996
Summary
Routine episiotomy, a common surgical procedure, lacks scientific evidence of benefit and may cause harm. Selective use is recommended, as routine episiotomy can lead to poorer sexual function and increased need for surgical repair.
Area of Science:
- Obstetrics and Gynecology
- Surgical Procedures
- Women's Health
Background:
- Episiotomy, a common surgical procedure, was historically introduced without robust scientific evidence.
- Its purported benefits include preventing severe perineal tears, improving sexual function, and reducing incontinence.
- However, the evidence supporting these claims has been questioned over time.
Purpose of the Study:
- To evaluate the scientific evidence regarding the benefits and harms of routine episiotomy.
- To compare outcomes between routine and selective episiotomy use.
- To provide evidence-based recommendations on episiotomy practices.
Main Methods:
- Systematic review and analysis of five randomized controlled trials (RCTs).
- Comparison of severe perineal tears, sexual function, pelvic floor muscle strength, and incontinence rates.
- Assessment of long-term effects associated with routine versus selective episiotomy.
Main Results:
- Selective episiotomy showed a 9% reduction in severe perineal tears, with variable effects.
- Routine episiotomy was associated with poorer future sexual function and increased need for surgical repair.
- No significant differences were observed in pelvic floor muscle strength or urinary incontinence between routine and selective use.
Conclusions:
- There is no reliable evidence supporting the beneficial effects of routine episiotomy.
- Routine episiotomy may lead to adverse outcomes, including impaired sexual function.
- The routine use of episiotomy should be abandoned, with rates exceeding 30% considered unjustified.