Differences in characteristics of mediolateral episiotomy in proffesionals at the same hospital

J Matern Fetal Neonatal Med. 2016;29(14):2368-72. doi: 10.3109/14767058.2015.1086328. Epub 2015 Sep 18.

Abstract

Objectives: The objective of our study was to compare the theoretical concept of the accoucheur in our institution with regard to the characteristics of the mediolateral episiotomy (MLE), with a crowning head and after a delivery.

Methods: We devised two simple pictorial questionnaires (one with a crowning head and the other in rest after a delivery) in order to explore possible differences in clinical practice between the accoucheurs of our institution with respect to the MLE characteristics.

Results: With a crowning head, we found more acute angles when the age of accoucheurs was greater than 35 years old and more than 15 years of experience, but no with the perineum at rest. No difference was found between doctors and midwives, nor between males and females. 28.1% of accoucheurs indicated an acuter episiotomy angle with a crowning head.

Conclusion: This study confirmed that the individual interpretation of MLE differed widely among professionals at the same hospital. These differences which have been shown could predispose women to a greater risk of anal sphincter injuries. For this reason, there is a need to standardize this practice, to make the technique more homogeneous, particularly in the context of future research into the risks and benefits of episiotomy with respect to major perineal trauma.

Keywords: Episiotomy technique; mediolateral episiotomy; obstetric anal sphincter injuries.

MeSH terms

  • Adult
  • Episiotomy / methods*
  • Female
  • Humans
  • Labor Presentation
  • Male
  • Nurse Midwives
  • Practice Patterns, Nurses' / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pregnancy
  • Spain
  • Surveys and Questionnaires