ArticleThe Australian & New Zealand journal of obstetrics & gynaecology2026
Episiotomy and Obstetric Anal Sphincter Injury in the Setting of Instrumental Vaginal Birth: A Retrospective Cohort Study.
Article in The Australian & New Zealand journal of obstetrics & gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEpisiotomy may be performed during an instrumental vaginal birth. The evidence that the procedure is associated with less obstetric anal sphincter injuries (OASI) in this setting is scarce.
aimsWe undertook a retrospective cohort study to ascertain whether the performance of episiotomy was associated with fewer obstetric anal sphincter injuries in patients undergoing instrumental births over a 14-year period from one tertiary institution. MATERIALS AND
methodsEvery vaginal birth at Te Toka Tumai Auckland from gestational age 36 weeks was included in a retrospective cohort spanning the years 2008-2021. Forceps-assisted and Vacuum-Extraction and Sequential Instrumental births were included. Univariable analysis was performed for the forceps, Vacuum-extraction and Sequential Instrumental birth strata. Multivariable analysis was performed for all births using generalized linear models including maternal, neonatal and labour characteristics.
resultsBetween 2008 and 2021 there were 3714 forceps-assisted births, 7793 Vacuum-extraction births and 505 Sequential Instrumental births. The majority of these births were carried out with the use of a mediolateral episiotomy (89%, 66%, and 93.5% respectively) and OASI occurred in 9.5%, 5.2%, and 16.2%. Among people having an instrumental birth (all groups forceps, vacuum-extraction and sequential instrumental births), mediolateral episiotomy was associated with lower relative risks of OASI after adjusting for type of instrument, parity and other clinical and demographic factors (RR 0.68 (0.58-0.80)).
conclusionMediolateral episiotomy was associated with a lower relative risk of OASI in patients having operative vaginal births.
Indexed as
Identifiers
What OpenQuestion holds
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.