Trial reportInternational urogynecology journal2018
No episiotomy versus selective lateral/mediolateral episiotomy (EPITRIAL): an interim analysis.
Trial report in International urogynecology journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 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
- National trends of episiotomy in non-instrumental vaginal deliveries (2013-2022): A multi-data source approach.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- 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
- Which elements were significant in reducing obstetric anal sphincter injury? A prospective follow-up study.BMC pregnancy and childbirth · 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: 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
- Atraumatic childbirth: is it a utopia?International urogynecology journal · 2020Article
- Episiotomy in modern clinical practice: friend or foe?International urogynecology journal · 2019Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisThe objective of this trial was to evaluate whether avoiding episiotomy can decrease the risk of advanced perineal tears. MATERIAL AND
methodsIn this randomized (1:1) parallel-group superiority trial, primiparous women underwent randomization into standard care (155 cases) vs. no episiotomy (154 cases) groups. The primary endpoint was the incidence of advanced (3rd- and 4th-degree) perineal tears. Secondary outcomes included perineal integrity, suturing characteristics, second-stage duration, incidence of postpartum hemorrhage, neonatal variables, and various postpartum symptoms 2 days and 2 months after delivery.
resultsAt prespecified 1-year interim analysis, the groups did not differ in terms of baseline demographic and obstetric characteristics. Six advanced perineal tears (3.9%) were diagnosed in the standard care group vs. two in no episiotomy group (1.3%), yielding a calculated odds ratio (OR) of 0.33 [95% confidence interval (CI) 0.06-1.65). Unexpectedly, rates of episiotomy performance also did not significantly vary between groups: 26.5% (41 cases) vs. 21.4% (33 cases), respectively, p = 0.35. No significant differences were noted in any secondary outcomes.
conclusionsNo difference in the rates of advanced perineal tears was found between groups; however, the main limitation of our study was unexpectedly high rates of episiotomy in the nonepisiotomy group. Thus, the main conclusion is that investigator monitoring and education should be continuously practiced throughout the trial duration, stressing the importance of adherence to the protocol.
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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.