Trial reportInternational urogynecology journal2020
Is it time to abandon episiotomy use? A randomized controlled trial (EPITRIAL).
Trial report in International urogynecology journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02356237 (The Effect of Episiotomy on Advanced Perineal Tears and Other Maternal and Fetal Outcomes - Randomized Controlled Multicentric Trial), which is not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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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.
The Effect of Episiotomy on Advanced Perineal Tears and Other Maternal and Fetal Outcomes - Randomized Controlled Multicentric Trial (EPITRIAL)
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Effect of Virtual Reality Application on Pain and Anxiety During Episiotomy Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.International urogynecology journal · 2024Pooled it
- Mediolateral/lateral episiotomy with operative vaginal delivery and the risk reduction of obstetric anal sphincter injury (OASI): A systematic review and meta-analysis.International urogynecology journal · 2022Pooled it
- Lateral episiotomy or no episiotomy in vacuum assisted delivery in nulliparous women (EVA): multicentre, open label, randomised controlled trial.BMJ (Clinical research ed.) · 2024Trial
- In women with spontaneous vaginal delivery, repair of perineal tears might be easier compared to episiotomy.International urogynecology journal · 2021Trial
- 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
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Clinical predictors of postpartum vaginal and vulvar hematomas and the need for surgical treatment.Pregnancy (Hoboken, N.J.) · 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
- Trigonometric characteristics of episiotomy & pregnancy variables.European journal of obstetrics & gynecology and reproductive biology: X · 2025Article
- Trends in induction of labour and associated co-morbidities and demographics in Queensland, Australia from 2001 to 2020: a population-based study.BMC pregnancy and childbirth · 2025Article
- Mediolateral episiotomy and obstetric anal sphincter injuries in nullipara: a propensity score matching study.BMC pregnancy and childbirth · 2025Article
- Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam.Healthcare (Basel, Switzerland) · 2023Article
- Navigating intensive altered states of consciousness: How can the set and setting key parameters promote the science of human birth?Frontiers in psychiatry · 2023Article
- In reply: Letter to the editor: Is it time to abandon episiotomy use? A randomized controlled trial (epitrial).International urogynecology journal · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisThe objective of this trial was to evaluate whether avoidance of episiotomy can decrease the risk of advanced perineal tears.
methodsIn this randomized (1:1) parallel-group superiority trial, primiparous women underwent randomization into "avoidance of episiotomy" (the study group in which episiotomy was allowed only in cases of fetal distress) or "standard care." The primary outcome was the incidence of advanced (3rd- and 4th-degree) perineal tears.
resultsThe participants were randomized into "standard care" (n = 337) vs. "no episiotomy" (n = 339) groups, not differing in any demographic or obstetric characteristics. Episiotomy rates were significantly lower in the study group (19.6%) compared with the standard care group (29.8%, p = 0.004). Five (1.5%) advanced tears were diagnosed in the study group vs. ten = 3.0% in the controls, yielding an odds ratio of 0.50 (95% CI 0.17-1.50) in favor of the "no episiotomy" group (p = 0.296). No differences were noted in any secondary outcomes. By per protocol analysis (omitting cases in which episiotomy was performed for indications other than fetal distress in the study group), a trend to decreased risk of advanced tears in the study group was noted (p = 0.0956). By per protocol analyses, no severe tears were noted in the 53 vacuum deliveries in the study group vs. 4/65 (6.2%) tears in the controls (p = 0.126).
conclusionsSince decreased use of episiotomy was not associated with higher rates of severe tears or any other adverse outcomes, we believe this procedure can be avoided in spontaneous as well as vacuum-assisted deliveries. Trial registration no. NCT02356237.
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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.