SynthesisWiener medizinische Wochenschrift (1946)2003
[Effectiveness of liberal vs. conservative episiotomy in vaginal delivery with reference to preventing urinary and fecal incontinence: a systematic review].
Synthesis in Wiener medizinische Wochenschrift (1946), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 5 citations in OpenAlex.
- Demographic variations and clinical associations of episiotomy and severe perineal lacerations in vaginal delivery.Journal of the National Medical Association · 2006Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Episiotomy is the most common surgical intervention in the world. In Europe the rate of episiotomy is approximately 30% (23). Reasons for this intervention are the reduction of risk for tears and incontinence. To assess the effects of restricted episiotomy in the prevention of urinary and faecal incontinence. Medline search for 1990-7/2002, Cochrane Library (Issue 2, 2002), GEROLIT and SOMED and the Internet. RCTs analysing restrictive or non-restrictive episiotomy were included if they had comprehensive randomisation, follow-up and exclusion of selection bias. Cohort studies were assessed to evaluate the risk of developing faecal incontinence. If possible, data were pooled. Included were all pregnant women with vaginal delivery. Intervention/exposition: Restrictive vs. liberal episiotomy (median, lateral or mediolateral). Incontinence rate (urine and stool) 3 months and 3 years post partum. All included randomised controlled studies met the criteria above, one randomised controlled study used blinded assessment of outcome parameter. Lots of follow-up was 33% (after 3 years). Cohort studies partly were retrospective. 2 randomised controlled studies measuring urinary incontinence were included. The rate for episiotomy was 60% in the intervention group with liberal episiotomy and 27% in the restricted group. No difference could be found in groups measuring urinary incontinence (RR 0.98, 95% CI 0.83-1.20). Only two included cohort studies measured the effect of episiotomy on faecal incontinence. The chance of developing faecal incontinence in association with episiotomy was more than threefold (OR = 3.64, 95% CI 2.15-6.14). Restrictive episiotomy neither effects the development of urinary incontinence of post partum women (RR 0.98 95%, CI 0.83-1.20) three months and three years after vaginal delivery, nor the risk for trauma. Women without episiotomy suffer significantly less from faecal incontinence (OR = 3.6). Further investigation is required to measure the effect of no intervention versus liberal episiotomy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.