PL EN


Preferences help
enabled [disable] Abstract
Number of results
Journal
2011 | 6 | 6 | 685-690
Article title

Current approach to episiotomy: Inevitable or unnecessary?

Content
Title variants
Languages of publication
EN
Abstracts
EN
An episiotomy is a surgical incision through the perineum made to provide sufficient area for the delivery of the infant. About 10 to 95% of women who deliver will have episiotomy depending on which part of the world they are having delivery.Too early episiotomy causes extensive bleeding and too late episiotomy causes the excessive stretching of a pelvic floor and lacerations could not be prevented.According to widely accepted arguments, there are many benefits of episiotomy for the neonate: prevention of injuries, shoulder dystocia and mental retardation of the infant. Benefits for the mother are: reduction of severe lacerations, prevention of sexual dysfunction, prevention of urinary and fecal incontinence. But those things could also be complications of episiotomy, if it is being used nonrestrictively. Some other complications are also extensive bleeding, hematoma or infection.There are many different opinions in literature about using episiotomy restrictively or routinely, so it is the right doubt arisen: is it inevitable or unnecessary?There is a wide variation in episiotomy practice, and the decision of performing it or not depends of actual clinical situation.There is still a great need for continuous obstetrics education according to the evidence based guidelines for the patient’s safety.
Keywords
Publisher
Journal
Year
Volume
6
Issue
6
Pages
685-690
Physical description
Dates
published
1 - 12 - 2011
online
8 - 10 - 2011
References
  • [1] Jevremovic M, Terzic M. Contemporary menagement of delivery. In: Bojovic S. (Editor): Human reproduction. Scientific book, Belgrade, 2003, pp. 912–927
  • [2] Allen RE, Hanson RW Jr. Episiotomy in low-risk vaginal deliveries. J Am Board Fam Pract 2005;18:8–12 http://dx.doi.org/10.3122/jabfm.18.1.8[Crossref]
  • [3] ACOG Practice Bulletin. Episiotomy. Clinical Management Guidelines for Obstetrician-Gynecologists Obstet Gynecol 2006;107:957–962
  • [4] Gabbe SG, DeLee JB. The prophylactic forceps operation.1920. Am J Obstet Gynecol 2002;187:254–255 http://dx.doi.org/10.1067/mob.2002.123205[Crossref]
  • [5] Woolley RJ. Benefits and risks of episiotomy: a review of the English-language literature since 1980. Obstet Gynecol Surv 1995;50:806–820 http://dx.doi.org/10.1097/00006254-199511000-00020[Crossref]
  • [6] Lappen R. J, Gossett R. Changes in episiotomy practice: evidence-based medicine in action. Expert Rev of Obstet Gynecol. 2010;5: 301–309 http://dx.doi.org/10.1586/eog.10.21[Crossref]
  • [7] Shiono P, Klebanoff MA, Carey JC. Midline episiotomies: more harm than good? Obstet Gynecol 1990;75:765–770
  • [8] Labrecque M, Bailargeon L, Daillaire M, Trembley A, Pinault JJ, Gingras S. Association between median episiotomy and severe perineal lacerations in primiparaous women. Can Med Assoc J 1997; 156: 797–802
  • [9] Fritel X, Schaal JP, Fauconnier A, Bertrand V, Levet C, Pigné A. Pelvic floor disorders 4 years after first delivery: a comparative study of restrictive versus systematic episiotomy. Br J Obstet Gynaecol 2008;115:247–252
  • [10] Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J, Lohr N.K Outcomes of Routine Episiotomy: a systematic review. JAMA. 2005;293:2141–2148 http://dx.doi.org/10.1001/jama.293.17.2141[Crossref]
  • [11] Ramin SM, Gilstrap LC III. Episiotomy and early repair of dehiscence. Clin Obstet Gynecol 1994;37:816–823 http://dx.doi.org/10.1097/00003081-199412000-00006[Crossref]
  • [12] Jovanovic N, Terzic M, Dotlic J, Aleksic S. Prevention of Postpartal Endometritis: Antibiotic of Choice. Srp Arh Celok Lek 2009; 137:506–510 http://dx.doi.org/10.2298/SARH0910506J[Crossref]
  • [13] Zizic V, Plecas D, Velimirovic M, Terzic M. The most frequent bacteriologic causes of puerperal infection. Giorn Mal Inf Parass 1990; 42:563–564
  • [14] Ugwumadu A, Manyonda I, Reid F, Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a andomised controlled trial. The Lancet 2003; 361: 983–988 http://dx.doi.org/10.1016/S0140-6736(03)12823-1[Crossref]
  • [15] Rorbye C, Petersen IS, Nilas L. Postpartum Clostridium sordellii infection associated with fatal toxic shock syndrome. Acta Obstet Gynecol Scand 2000;79:1134–1135
  • [16] Morris WE, Fernández-Miyakawa ME. Toxins of Clostridium perfringens. Rev Argent Microbiol 2009; 41:251–260 [PubMed]
  • [17] Langer B, Minetti A. Immediate and long term complications of episiotomy. J Gynecol Obstet Biol Reprod 2006; 35:1S59–1S67 [Crossref]
  • [18] Dinulović D, Terzić M. Injuries of the birth canal during childbirth. In: Dinulović D. (Editor). Obstetrics. Službeni glasnik SRJ, Belgrade, 1996, pp. 436–446
  • [19] Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database Syst Rev 2009:1:CD000081
  • [20] Goldman JC, Robinson J.N.The role of episiotomy in current obstetric practice. Semin Perinatol. 2003; 27: 3–12 http://dx.doi.org/10.1053/sper.2003.50000[Crossref]
  • [21] Frudinger A, Bartram CI, Spencer JAD, Kamm MA. Perineal examination as a predictor of underlying external anal sphincter damage. Br J Obstet Gynecol 1997; 104:1009–1013 http://dx.doi.org/10.1111/j.1471-0528.1997.tb12058.x[Crossref]
  • [22] Alperin M, Krohn MA, Parviainen K. Episiotomy and increase in the risk of obstetric laceration in a subsequent vaginal delivery. Obstet Gynecol 2008;111:1274–1278 http://dx.doi.org/10.1097/AOG.0b013e31816de899[Crossref]
  • [23] Landy HJ, Laughon SK, Bailit JL, Kominiarek MA, Gonzalez-Quintero VH, Ramirez M et al. Characteristics associated with severe perineal and cervical lacerations during vaginal delivery. Obstet Gynecol 2011;117:627–635 http://dx.doi.org/10.1097/AOG.0b013e31820afaf2[Crossref][WoS]
  • [24] Eason E, Labrecque M, Wells G, Feldman P. Preventing perineal trauma during childbirth: a systematic review. Obstet Gynecol 2000;95:464–471 http://dx.doi.org/10.1016/S0029-7844(99)00560-8[Crossref]
  • [25] Persson J, Wolner-Hanssen P, Rydhstroem H. Obstetric risk factors for stress urinary incontinence: A population-based study. Obstet Gynecol 2000;96; 440-445 [PubMed][Crossref]
  • [26] Casey BM, Schaffer JI, Bloom SL, Heartwell SF, McIntire DD, Leveno KJ. Obstetric antecedents for postpartum pelvic floor dysfunction. Am J Obstet Gynecol 2005;192:1655–1662 http://dx.doi.org/10.1016/j.ajog.2004.11.031[Crossref]
  • [27] Viswanathan M, Hartmann K, Palmieri R, Lux L, Swinson T, Lohr KN et al. The Use of Episiotomy in Obstetrical Care: A Systematic Review. Evid Rep Technol Assess. 2005; 112:1–8
  • [28] Rockner G. Urinary incontinence after perineal trauma at childbirth. Scand J Caring Sci 1990;4:169–172 [Crossref][PubMed]
  • [29] Arrue M, Ibanez L, Paredes J, Murgiondo A., Belar M, Sarasqueta C et al. Stress urinary incontinence six months after first vaginal delivery. Eur J Obstet Gynecol Reprod Biol 2010; 210–214 [PubMed]
  • [30] Sartore A, De Seta F, Maso G, Pregazzi R, Grimaldi E, Guaschino S. The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery. Obstet Gynecol 2004;103:669–673 http://dx.doi.org/10.1097/01.AOG.0000119223.04441.c9[Crossref]
  • [31] Andrews V, Sultan AH, Thakar R, Jones PW. Risk factors for obstetric anal sphincter injury: a prospective study. Birth 2006; 33:117–122 http://dx.doi.org/10.1111/j.0730-7659.2006.00088.x[Crossref]
  • [32] Wheeler T, Richter HE. Delivery method, anal sphincter tears and fecal incontinence: new information on a persistent problem. Curr Opin Obstet Gynecol 2007;19:474–479 http://dx.doi.org/10.1097/GCO.0b013e3282ef4142[Crossref][WoS]
  • [33] Signorello LB, Harlow BL, Chekos AK, Repke JT. Midline episiotomy and anal incontinence: retrospective cohort study.BMJ 2000;320:86–90 http://dx.doi.org/10.1136/bmj.320.7227.86[Crossref]
  • [34] Pirro N, Sastre B, Sielezneff I. What are the risk factors of anal incontinence after vaginal delivery? J Chir 2007;144:197–202 http://dx.doi.org/10.1016/S0021-7697(07)89514-7[Crossref][WoS]
  • [35] Terzic M. Internal genital organs. In: Milisavljevic M. (Editor): Clinical anatomy. Science, Belgrade, 1996, pp. 436–446
  • [36] Buhling KJ, Schmidt S, Robinson JN, Klapp C, Siebert G, Dudenhausen JW.Rate of dyspareunia after delivery in primiparae according to mode of delivery. Eur J Obstet Gynecol Reprod Biol. 2006;124:42–46 http://dx.doi.org/10.1016/j.ejogrb.2005.04.008[Crossref]
  • [37] Sayasneh A, Pandeva I. Postpartum sexual disfunction. A literature review of risk factors and role of mode of delivery. BJMP 2010; 3:316–320
  • [38] Ejegard H, Ryding EL, Sjogren B. Sexuality after delivery with episiotomy: A long-term follow-up. Gynecol Obstet Investig 2008; 66:1–7 [WoS]
  • [39] Danielsson I, Sjoberg I, Stenlund H, Wikman M. Prevalence and incidence of prolonged and severe dyspareunia in women: results from a population study. Scand J Public Health 2003;31:113–118 http://dx.doi.org/10.1080/14034940210134040[Crossref]
  • [40] Joshi A, Acharya R. Perineal outcome after restrictive use of episiotomy in primi-gravidas. J Nepal Med Assoc 2009;48:269–272
  • [41] Fritel X. Pelvic floor and pregnancy. Gynecol Obstet Fertil 2010; 38:332–346 http://dx.doi.org/10.1016/j.gyobfe.2010.03.008[WoS][Crossref]
  • [42] Adamo V, Di Natale W, Meola C, Gilio M, Cavalli S, Ferrari L et al. Endometriosis in episiotomy scar: a case report. 2004;56:735–738
  • [43] Baloglu A, Uysal D, Aslan N, Yigit S. Advanced stage of cervical carcinoma undiagnosed during antenatal period in term pregnancy and concomitant metastasis on episiotomy scar during delivery: a case report and review of the literature. Int JGynecol Cancer. 2007;17:1155–1159 http://dx.doi.org/10.1111/j.1525-1438.2007.00926.x[WoS][Crossref]
Document Type
Publication order reference
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_s11536-011-0088-z
Identifiers
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.