Document Detail

Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women.
MedLine Citation:
PMID:  18221925     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to determine whether selective midline episiotomy contributes to the prevention of third- or fourth-degree perineal lacerations. STUDY DESIGN: A randomized controlled clinical trial was performed with 446 nulliparous women with deliveries after 28 weeks of pregnancy. Patients were randomized to undergo either routine episiotomy or selective episiotomy. In the selective episiotomy group, episiotomies were performed only in cases of imminent lacerations, fetal distress, or forceps delivery. RESULTS: In the group of 223 patients who underwent routine episiotomy, 32 (14.3%) had third- or fourth-degree perineal lacerations, as compared to 15 (6.8%) in the group of 222 patients undergoing selective episiotomy (relative risk, 2.12; 95% confidence interval, 1.18-3.81). Only reduction in third-degree lacerations was significant when analyzed separately. Moreover, periurethral, labia minora, and superficial vaginal lacerations were significantly more frequent in the selective episiotomy group. CONCLUSION: The policy of performing selective midline episiotomy in nulliparous patients results in a reduction in the risk of third-degree perineal lacerations.
Alexander Rodriguez; Edgar A Arenas; Alba L Osorio; Omar Mendez; John J Zuleta
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-01-25
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  198     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  285.e1-4     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, San Vicente de Paul Hospital, Antioquia University Medical School, Medellín, Colombia.
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MeSH Terms
Episiotomy / methods*
Injury Severity Score
Lacerations / classification,  epidemiology,  prevention & control*

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