Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 9 , ISSUE 3 ( July-September, 2017 ) > List of Articles

RESEARCH ARTICLE

Restricted Use of Episiotomy

Anju Sharma, Nupur Hooja, Brijesh Dadhich, Sapna Aseri, Avantika Sharma, Bhomraj Kumawat

Citation Information : Sharma A, Hooja N, Dadhich B, Aseri S, Sharma A, Kumawat B. Restricted Use of Episiotomy. J South Asian Feder Obs Gynae 2017; 9 (3):260-262.

DOI: 10.5005/jp-journals-10006-1507

License: CC BY 3.0

Published Online: 01-04-2013

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim

There is extensive disagreement about the necessity and benefits of routine episiotomy for all. The American Congress of Obstetricians and Gynecologists Committee on Practice Bulletins, 2006 based on good scientific evidence recommends restricted use of episiotomy to be preferred, yet its restricted use is not being practiced. Keeping these in mind, the study was done with the aim to assess the effects of restrictive use of episiotomy during vaginal birth.

Materials and methods

This was a prospective study. Singleton primigravida term vaginal deliveries over 3 months were included. Under the policy of restricted use of episiotomy, great restraint was observed in giving an episiotomy. Mediolateral episiotomy was given in women where expected baby weight >3 kg or perineal tear was anticipated, and in cases of instrumental deliveries. Perineal tears, postpartum status, and satisfaction level of women were compared between patients with or without episiotomy. Data so obtained were analyzed.

Results

About 29.8% women delivered with episiotomy, 65.5% had intact perineum; 5.67% women had first-degree perineal tear and only 1.42% women had second-degree perineal tear using a policy of restricted use of episiotomy. None of the women had third- and fourth-degree perineal tear. Patients delivered without episiotomy were more comfortable in terms of less perineal pain, early evacuation of bladder, and ambulation.

Conclusion

With the restricted use of episiotomy using precise clinical judgment, the unnecessary episiotomies could be avoided, giving better care and patient satisfaction with minimum maternal morbidity.

Clinical significance

The policy of restricted use of episiotomy would result in considerable reduction in maternal morbidity, decreased hospital stay and overall cost, and good patient satisfaction level.

How to cite this article

Dadhich B, Hooja N, Sharma A, Aseri S, Sharma A, Kumawat B. Restricted Use of Episiotomy. J South Asian Feder Obst Gynae 2017;9(3):260-262.


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  1. Episiotomy use in the United States, 1979-1997. Obstet Gynecol 2002 Dec;100(6):1177.
  2. Episiotomy in the United States: has anything changed? Am J Obstet Gynecol 2009 May;200(5):573.
  3. Variation in and factors associated with use of episiotomy. JAMA 2015 Jan;313(2):197-199.
  4. Factors influencing the use of episiotomy during vaginal delivery in South Eastern Nigeria. East Afr Med J 2008 May;85(5):240-243.
  5. What are the epidemiologic data in regard to episiotomy? J Gynecol Obstet Biol Reprod (Paris) 2006 Feb;35(1 Suppl):1S12-1S23.
  6. Episiotomy. Clinical Management Guidelines for Obstetrician Gynecologists. Number 71, April 2006. Obstet Gynecol 2006 Apr;107(4):957-962.
  7. Episiotomy for vaginal birth. Cochrane Database Syst Rev 2009 Jan;(1): Art. No.: CD000081.
  8. Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing? BMC Health Serv Res 2015 Jan;15(1):95.
  9. Outcomes of routine episiotomy: a systematic review. JAMA 2005 May;293(17):2141-2148.
  10. Knowledge, attitude and experience of episiotomy use among obstetricians and midwives in Viet Nam. BMC Pregnancy Childbirth 2015 Apr;15:101.
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