ArticleArchives of gynecology and obstetrics2026
Episiotomy and the risk of obstetric anal sphincter injury in nulliparous women with a prolonged second stage.
Article in Archives of gynecology and obstetrics, 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
purposeThis study aimed to evaluate whether episiotomy reduces obstetric anal sphincter injuries (OASIS) rates in nulliparous women with a second stage of labor lasting ≥ 3 h.
methodsThis retrospective study focused on nulliparous women at ≥ 36 weeks of gestation with singleton pregnancies who experienced a second stage of labor lasting ≥ 3 h and ultimately achieved spontaneous, non-operative, vaginal delivery between 2014 and 2024. Participants were categorized into two groups based on their episiotomy status. The primary outcome was the occurrence of OASIS, namely third- and fourth-degree perineal lacerations.
resultsThe study included 1164 (58.3%) women who underwent episiotomy and 831 (41.7%) who did not. Women in the episiotomy group were significantly younger (27.79 ± 4.31 vs. 28.47 ± 4.51 years, p < 0.001), had a higher prevalence of hypertensive disorders (7.7% vs. 5.2%, p = 0.029), experienced a slightly longer second stage of labor (3.62 ± 0.4 vs. 3.53 ± 0.4 h, p < 0.001), and delivered newborns with higher birthweight (3366 ± 390 vs. 3284 ± 376 g, p < 0.001). The OASIS rates were comparable between the groups (1.9% vs. 2.2%, p = 0.82), consistent across all subtypes and in a subanalysis of women with a second stage of ≥ 4 h (2.9% vs. 2.5%, p = 0.59). In adjusted multivariable analysis, episiotomy was not associated with OASIS (adjusted OR 0.95, 95% CI 0.48-1.84).
conclusionIn nulliparous women with spontaneous vaginal delivery and a prolonged second stage (≥ 3 h), episiotomy was not associated with a reduced risk of OASIS, even when the second stage exceeded 4 h. Our findings support existing guidelines that advocate against routine episiotomy in this population.
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.