Is it time to abandon episiotomy use? A randomized controlled trial (EPITRIAL)

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.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research

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The objective is to determine the prevalence of levator ani muscle (LAM) avulsion using four-dimensional ultrasound in primiparous women after vaginal delivery and according to delivery mode.MethodsThis prospective, multicenter study included 322 women evaluated at 6 –12 months postpartum by four-dimensional transperineal ultrasound to identify levator ani muscle avulsion. The researcher who performed the ultrasound was blinded to all clinical data. Meaningful data about the birth were also recorded: mode of delivery, mother’s age and body mass index, durat ion of second stage, episiotomy, perineal tearing...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionsSonographic large fetal HC is associated with OASIS occurrence during VAD. The only modifiable predictor of OASIS detected was mediolateral episiotomy, found to be protective against OASIS.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
Conclusion: Interventions, with the exception of episiotomies, did not have an influence on the occurrence of perineal trauma, but they do need to be carefully assessed. Deliveries in a horizontal position were associated with a higher likelihood of performing an episiotomy.Resumen Objetivo: Identificar las asociaciones entre el resultado perineal en prim íparas y las intervenciones ocurridas durante el trabajo de parto, parto, peso y APGAR del recién nacido. Método: Estudio documental, correlacional, retrospectivo, cuantitativo, llevado a cabo en una maternidad terciaria en el estado de Ceará, ...
Source: Revista da Escola de Enfermagem da USP - Category: Nursing Source Type: research
AbstractIntroduction and hypothesisThis time-series analysis was carried out to determine if the use of the EPISCISSORS-60 ®, episiotomy scissors specifically designed to achieve a cutting angle of 60°, would continue to sustain obstetric anal sphincter injuries (OASIS) reductions at our hospital 2 years after its introduction.MethodsWe compared data from 2,342 women delivered in 2014 (prior to the introduction of EPISCISSORS-60 ®) with that of 4,498 women delivered from 2016 to 2017 (after the introduction of EPISCISSORS-60®).ResultsThere was a reduction of OASIS in all nulliparous vaginal deliveries ...
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
ConclusionsLateral and mediolateral episiotomies are independent modifiable predictors of OASI, protective against OASI in SVDs when neonates weigh>  3000 g and 2500–3499 g in VADs.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionsPFM function and UI prevalence at 6  weeks postpartum are not significantly affected by epidural analgesia.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
The objective of this study is the generation of descriptive data on the mode of delivery and on maternal and foetal complications in the case of foetal macrosomia. The causes and consequences of foetal macrosomia as well as the rate of shoulder dystocia are examined in relation to the severity of the macrosomia. Patients The study investigated all singleton births ≥ 37 + 0 weeks of pregnancy with a birth weight ≥ 4000 g at the Charité University Medicine Berlin (Campus Mitte 2001 - 2017, Campus Virchow Klinikum 2014 - 2017). Results 2277 consecutive newborns (birth w...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
Abstract BACKGROUND: The rate of obstetric anal sphincter injury has increased in recent years, particularly among operative vaginal deliveries. We sought to characterize temporal trends in episiotomy use and to quantify the association between episiotomy and obstetric anal sphincter injury. METHODS: Using a population-based retrospective cohort study design of hospital data from 2004 to 2017, we studied all vaginal deliveries of singleton infants at term gestation in Canada (excluding Quebec). Rates of obstetric anal sphincter injury were contrasted between women who had an episiotomy and those who did not. ...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research
Publication date: Available online 9 July 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): A.H. Sultan, R. Thakar, K.M. Ismail, V. Kalis, K. Laine, S.H. Räisänen, J.W. de LeeuwAbstractThe role of episiotomy with regard to prevention of anal sphincter injuries (OASIS) is under discussion. The recently published guideline of the WHO “Intrapartum care for a positive childbirth experience” states that the role of episiotomy during operative vaginal deliveries remains to be established. This guideline is based on the evidence coming from randomised clinical tria...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionsVBAC does not confer an increased risk of OASI after a first delivery by caesarean section when compared with nulliparous women. The rate of successful VBAC may be contributory and suggests that the risk conferred by VBAC may be unit-specific. Unit and national-level audit is necessary to investigate this risk further.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
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