ArticleArchives of gynecology and obstetrics2020
Selective use of episiotomy: what is the impact on perineal trauma? Results from a retrospective cohort study.
Article in Archives of gynecology and obstetrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- The effects of warm perineal compress on perineal trauma and postpartum pain: a systematic review with meta-analysis and trial sequential analysis.Archives of gynecology and obstetrics · 2024Pooled it
- Prevalence, indications and fetal outcomes of operative vaginal delivery in Sub-Saharan Africa, systematic review, and meta-analysis.BMC women's health · 2023Pooled it
- Episiotomy practice and perineal outcomes in low risk vaginal deliveries: comparing a hospital attached birth center and delivery suite in Beirut, Lebanon.Future science OA · 2026Article
- A Systematic Review of the Use of Routine Versus Selective Episiotomy for Vaginal Birth.Cureus · 2024Review
- Pelvic floor symptoms according to the severity of second-degree perineal tears within 12 months post-partum: A longitudinal prospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Vacuum-assisted delivery outcomes: is advanced maternal age a factor?Archives of gynecology and obstetrics · 2024Article
- Delivery in a vertical birth chair supported by freedom of movement during labor: A randomized control trial.Open medicine (Warsaw, Poland) · 2023Article
- The relationship between perineal size and episiotomy during delivery.Journal of medicine and life · 2022Article
- Detailed classification of second-degree perineal tears in the delivery ward: an inter-rater agreement study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- A nationwide cross-sectional survey of episiotomy practice in China.The Lancet regional health. Western Pacific · 2022Article
- Perianal Diseases in Pregnancy and After Childbirth: Frequency, Risk Factors, Impact on Women's Quality of Life and Treatment Methods.Frontiers in surgery · 2022Review
- Effects of lateral episiotomy on the emergence of urinary incontinence during the first postpartum year in primiparas: prospective cohort study.Przeglad menopauzalny = Menopause review · 2021Article
- Which elements were significant in reducing obstetric anal sphincter injury? A prospective follow-up study.BMC pregnancy and childbirth · 2021Article
- Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population-Multicentric Comparative Study with Adult Population.International journal of environmental research and public health · 2021Article
- Pelvic floor dysfunction one year after first childbirth in relation to perineal tear severity.Scientific reports · 2021Article
- Client-care provider interaction during labour and birth as experienced by women: Respect, communication, confidentiality and autonomy.PloS one · 2021Article
- Between neo-classification of second-degree lacerations and paucity of retrospective data.Archives of gynecology and obstetrics · 2020Article
- Rome wasn't built in a day: step-by-step improvement of obstetric care in the labor ward.Archives of gynecology and obstetrics · 2020Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the effects of selective use of episiotomy on perineal trauma.
methodsWe performed a retrospective cohort study on consecutive vaginal deliveries from January 2010 to December 2016. From January 2010 to December 2011 episiotomy was performed liberally, based only on individual midwife/doctor's decision. Since January 2012, a shared selective use of episiotomy policy has been introduced. To evaluate the range of perineal trauma in spontaneous second-degree perineal tears, a sub-classification of second-degree lacerations has been introduced dividing them into two sub-groups: A (smaller than the average episiotomy) and B (spontaneous vaginal tear larger than the average episiotomy). The primary outcomes were the incidence and type of perineal trauma, with the proportion of type A and type B second-degree spontaneous tears under a policy of selective episiotomy.
resultsDeliveries not exposed to selective use of episiotomy were 1583 (Group 1), those exposed to selective use of episiotomy were 6409 (Group 2). In Group 2 episiotomy rate decreased, and incidence of intact perineum, first- and second-degree lacerations increased. The incidence of third- and fourth-degree lacerations did not change. Spontaneous second-degree lacerations occurred in 19.4% and 36.8% of women in group 1 and 2, respectively. With a selective episiotomy policy, 88.3% of second-degree tears was classified as type A.
conclusionsThe selective use of episiotomy is clinically feasible and effective. This policy seems to be associated with a lower delivery-related perineal trauma as showed by the sub-classification, that could be a useful tool to monitor obstetric care.
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