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Am J Obstet Gynecol. 2012 May;206(5):404.e1-5. doi: 10.1016/j.ajog.2012.02.008. Epub 2012 Mar 15.

The effect of a mediolateral episiotomy during operative vaginal delivery on the risk of developing obstetrical anal sphincter injuries.

Author information

1
Department of Obstetrics and Gynaecology, Amphia Hospital Breda, Breda, The Netherlands. joeydevogel@gmail.com

Abstract

OBJECTIVE:

The objective of the study was to evaluate the frequency of obstetrical anal sphincter injuries (OASIS) in women undergoing operative vaginal deliveries (OVD) and to assess whether a mediolateral episiotomy is protective for developing OASIS in these deliveries.

STUDY DESIGN:

We performed a retrospective cohort study. Maternal and obstetrical characteristics of the 2861 women who delivered liveborn infants by an OVD at term in the years 2001-2009 were extracted from a clinical obstetrics database and were analyzed in a logistic regression model.

RESULTS:

The frequency of OASIS was 5.7%. Women with a mediolateral episiotomy were at significantly lower risk for OASIS compared with the women without a mediolateral episiotomy in case of an OVD (adjusted odds ratio, 0.17; 95% confidence interval, 0.12-0.24).

CONCLUSION:

We found a 6-fold decreased odds for developing OASIS when a mediolateral episiotomy was performed in OVD. Therefore, we advocate the use of a mediolateral episiotomy in all operative vaginal deliveries to reduce the incidence of OASIS.

PMID:
22425401
DOI:
10.1016/j.ajog.2012.02.008
[Indexed for MEDLINE]

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