Evaluation of the incision angle of mediolateral episiotomy at 60 degrees

Abstract

An incision angle of mediolateral episiotomy of 60° resulted in a low incidence of anal sphincter tearing, anal incontinence and perineal pain. A randomized controlled trial is needed to assess the outcome when different angles of episiotomy are used.

Risk factors for obstetric anal sphincter injuries and postpartum anal and urinary incontinence: a case–control trial

“…Whether episiotomy is causative of OASIS or not has been a controversy in multiple papers, with some citing it as a cause and others citing episiotomy as protective [20][21][22]. Recent evidence suggests that more lateral episiotomies might be protective and more medial episiotomies might be causative [23][24][25][26]. The way in which episiotomy was performed in our hospital was not standardised.…”

Obstetric anal sphincter injuries: review of anatomical factors and modifiable second stage interventions

“…Kalis et al were the first to report data on the difference between the incision angle and suture angle of the episiotomy [35,36]. A 40°premarked episiotomy results in a postdelivery suture angle of 22°, while a 60°premarked episiotomy results in a suture angle of 45°.…”

Different episiotomy techniques, postpartum perineal pain, and blood loss: an observational study

“…A correct mediolateral angle was defined as an angle ranging between 50 and 80 degrees, due to new evidence suggesting that an angle of at least 60 degrees is necessary to minimize the risk of OASI (26,43). We allowed a slightly narrower mediolateral angle than 60 degrees (down to 50 degrees), due to the fact that a photo (even if shown in an anatomical true scale) is not equivalent to a clinical setting.…”