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Episiotomy: the final cut?
Archives of Gynecology and Obstetrics, 07/27/2012
Clinical Article
Steiner N et al. –This retrospective study investigates whether episiotomy prevents 3rd or 4th degree perineal tears in critical conditions such as shoulder dystocia, instrumental deliveries (vacuum or forceps), persistent occiput–posterior position, fetal macrosomia (>4,000 g), and non–reassuring fetal heart rate (NRFHR) patterns. It was seen that mediolateral episiotomy is an independent risk factor for 3rd or 4th degree perineal tears, even in critical conditions such as shoulder dystocia, instrumental deliveries, occiput–posterior position, fetal macrosomia, and NRFHR. Prophylactic use of episiotomy in these conditions does not seem beneficial if performed to prevent 3rd or 4th degree perineal tears.
