Trial reportReproductive health2017
Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial.
Trial report in Reproductive health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT02178111 (Not Performing Episiotomy Versus Selective Episiotomy), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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.
Not Performing Episiotomy Versus Selective Episiotomy: a Randomized Clinical Trial
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis.International urogynecology journal · 2020Pooled it
- Is it time to abandon episiotomy use? A randomized controlled trial (EPITRIAL).International urogynecology journal · 2020Trial
- No episiotomy versus selective lateral/mediolateral episiotomy (EPITRIAL): an interim analysis.International urogynecology journal · 2018Trial
- Network meta-analysis of episiotomy approaches: comparing routine, restrictive, and non-episiotomy strategies and their effects on maternal and neonatal outcomes in primiparous patients.Reproductive health · 2025Review
- Maternal and neonatal outcomes of childbirth care in a Freestanding Birth Centre.Revista latino-americana de enfermagem · 2025Observational
- Trends and determinants of the use of episiotomy in a prospective population-based registry from central India.BMC pregnancy and childbirth · 2024Article
- Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam.Healthcare (Basel, Switzerland) · 2023Article
- Perinatal health among migrant women: A longitudinal register study in Finland 2000-17.SSM - population health · 2022Article
- The relationship between perineal size and episiotomy during delivery.Journal of medicine and life · 2022Article
- Episiotomy for Medical Indications during Vaginal Birth-Retrospective Analysis of Risk Factors Determining the Performance of This Procedure.Journal of clinical medicine · 2022Article
- Selective versus routine use of episiotomy for vaginal births in Shanghai hospitals, China: a comparison of policies.BMC pregnancy and childbirth · 2022Article
- Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership.BMC pregnancy and childbirth · 2021Observational
- Perspectives of skilled birth attendants and pregnant women regarding episiotomy: a quantitative approach.African health sciences · 2021Article
- In reply: Letter to the editor: Is it time to abandon episiotomy use? A randomized controlled trial (epitrial).International urogynecology journal · 2020Article
- Letter to the editor: selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis.International urogynecology journal · 2020Article
- Observational
- Episiotomy related morbidities measured using redness, edema, ecchymosis, discharge and apposition scale and numerical pain scale among primiparous women in Mulago National Referral Hospital, Kampala, Uganda.The Pan African medical journal · 2020Article
- Knowledge, Attitude and Practice of Brazilian Obstetricians Regarding Episiotomy.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2019Article
- Attention to childbirth and delivery in a university hospital: comparison of practices developed after Network Stork.Revista latino-americana de enfermagem · 2019Article
- Correction to: Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial.Reproductive health · 2017Article
Corrections and comments
- Erratum issuedCorrection to: Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial.2017 · M Amorim, M [corrected to Amorim, Melania M]
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite all the evidence corroborating the selective use of episiotomy and although routine use of the procedure is contraindicated, there are no evidences corroborating if episiotomy is necessary in any circumstance. The present clinical randomized trial was performed to compare maternal and perinatal outcomes in women submitted to a non-episiotomy protocol versus one of selective episiotomy.
methodsAn open-labelled, randomized clinical trial was carried out in a tertiary teaching hospital in Recife, Northeastern Brazil. Women in labor with a full-term live foetus, dilatation of 6 to 8 cm and cephalic presentation (vertex position) were included. Exclusion criteria consisted of bleeding disorders and an indication for a caesarean section. After signing the consent form, 241 women were randomized to a non-episiotomy protocol (the experimental group) or to a selective episiotomy group (the control group). No episiotomies were to be performed in the experimental group except under exceptional circumstances. In the control group, selective episiotomies were to be performed in accordance with the healthcare professionals' clinical judgement. Maternal and perinatal outcomes were evaluated. Ratio Risk (RR) and the 95% confidence interval (95% CI) were calculated for our outcomes.
resultsThe analysis include 115 women assigned to a non-episiotomy protocol and 122 to selective episiotomy. There was no difference between the two groups with respect to maternal or perinatal outcomes. The episiotomy rate was similar (two cases in each group, about 1.7%), as was the duration of the second stage of labor, the frequency of perineal tears, severe perineal trauma, need for perineal suturing and blood loss at delivery.
conclusionsA non-episiotomy protocol appears to be safe for mother and child, and highlights the need to investigate whether there is, in fact, any indication for this procedure.
trial registrationThis trial was registered at ClinicalTrials.gov under reference number ( NCT02178111 ).
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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.