Evaluation of Episiotomy and Spontaneous Tears of Perineum during Childbirth

Röckner, Gunny; Henningsson, Annelie; Wahlberg, Vivian; Ölund, Anders

doi:10.1111/j.1471-6712.1988.tb00026.x

Cited by 23 publications

(17 citation statements)

References 15 publications

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“…However, comparison of the antepartum and postpartum muscle function scores suggested that the degree to which women regained perineal muscle function after birth was positively related to perineal trauma at delivery: those with the least perineal trauma (the intact and cesarean groups) had the greatest positive change in scores. The finding that the group of women who received an episiotomy was the only group to exhibit a net loss of perineal muscle function after delivery is consistent with that of Rockner et al 19 and adds further support to the contention that routine episiotomy or episiotomy to prevent a laceration may actually contribute to a decline in function.…”

Section: Discussionsupporting

confidence: 84%

Changes in Postpartum Perineal Muscle Function in Women With and Without Episiotomies

Fleming

Newton

Roberts

2003

J Midwife Womens Health

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This report presents results of a comparison perineal muscle function between antepartum and postpartum measurements in a cohort of women with different perineal conditions after childbirth. Data were obtained by using prospective electromyographic perineometry measurements to objectively determine perineal muscle function before and after delivery in 102 women. In addition, 24 nulliparous, non-pregnant women were studied to determine the effect of pregnancy on perineal muscle function. Pregnancy is associated with a decrease in perineal muscle strength and endurance compared with the postpartum state. The degree to which women improved or did not improve perineal muscle function after birth was related to perineal trauma at delivery. After controlling for parity, maternal age, birthweight, smoking status, and antepartum scores, the order of best to worst performance was cesarean birth, intact perineum, first-degree perineal injury, second- or third-degree perineal injury, and episiotomy. Pre- and post-delivery scores were compared for each woman and analyzed according to perineal outcome. Although all other perineal outcome groups increased muscle function by 6 months postpartum, women with an episiotomy had a mean net loss of perineal muscle performance after birth. These observations do not support the use of episiotomy for the purpose of preserving perineal muscle function.

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Section: Discussionsupporting

confidence: 84%

Changes in Postpartum Perineal Muscle Function in Women With and Without Episiotomies

Fleming

Newton

Roberts

2003

J Midwife Womens Health

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“…During this time, the number of partial or total ruptures of the anal sphincter fell from 1.6 to 1.1 %, but this reduction is not significant (p > 0.05). These results are in accordance with those of Rockner et al [8,9], A decrease in the episiotomy frequency does not seem to be disadvantageous for the mother since the frequency of sphincter ruptures is unaltered. The patient comfort increases and the perineal healing progresses better if an episiotomy is avoided.…”

Section: Discussionsupporting

confidence: 82%

Advantage or Disadvantage of Episiotomy Compared with Spontaneous Perineal Laceration

Larsson

Platz-Christensen

Bergman

et al. 1991

Gynecol Obstet Invest

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In a prospective clinical investigation of 2,144 deliveries, we elucidate the indications for episiotomy and how different methods of anesthesia affect the frequency of episiotomy and the perineal problems after episiotomy compared with those after spontaneous perineal laceration. We found a significantly higher infection rate (p < 0.001) and a longer healing period in the episiotomy group. These differences remain even if only primigravida or the indication, imminent perineal laceration, is studied. The results indicate that many women will unnecessarily suffer after an episiotomy. The patient’s subjective problems are significantly increased, both immediately and at the 3-month postoperative follow-up.

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“…Although it is said to be difficult to clearly attribute rates of infection to episiotomy (Thacker and Banta, 1983). The infection rate obtained in this study is lower than that obtained by Larsson et al (1991), with infection rate at 10% and Rockner et al (1988), with 22% infection rate. They had microscopy, culture and sensitivity studies done on the swabs taken from the infected sites and appropriat e antibiotic regimen was administered based on the sensitivity results.…”

Section: Discussioncontrasting

confidence: 80%