The outcomes of midline versus medio-lateral episiotomy

Sooklim, Ratchadawan; Thinkhamrop, Jadsada; Lumbiganon, Pisake; Prasertcharoensuk, Witoon; Pattamadilok, Jeerichuda; Seekorn, Kanok; Chongsomchai, Chompilas; Pitak, Prakai; Chansamak, Sukanya

doi:10.1186/1742-4755-4-10

Cited by 39 publications

(23 citation statements)

References 13 publications

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“…Our finding suggests that an increased use of episiotomy among HIV positive women with imminent tear may have reduced the rate of perineal tears in this group. Episiotomies are easier to repair as opposed to perineal tears African Journal of Reproductive Health December 2017; 21 (4): 71 which may also extend to involve the anal sphincter and rectum making repair more difficult 16 . However, no patient in the study had third or fourth perineal tears.…”

Section: Discussionmentioning

confidence: 99%

An Audit of Perineal Trauma and Vertical Transmisson Of HIV

Ocheke

Samuels

Ocheke

et al. 2017

Afr J Reprod Health

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Restrictive episiotomy is recommended for the prevention of vertical transmission of HIV. The study compared the frequency of episiotomy use and the occurrence of perineal tears; and related factors in HIV positive and HIV negative women and to assess their effect on Mother-to-child transmission (MTCT) of HIV. A total of 110 HIV positive and 134 HIV negative parturients were enrolled in the study. The incidence of episiotomy was more in the HIV negative group (p=0.0000) while that of perineal tear was not affected by HIV status (p=0.17). The rate of episiotomy was significantly affected by primigravidity in HIV negative subjects (OR= 0.032, 95% CI 0.0072-0.13). The rate of perineal tear was significantly affected by primigravidity in HIV positive subjects (OR=8.55, 95% CI 1.91-38.7) and multigravidity in HIV negative subjects (OR= 0.030, 95% CI 0.133-0.71). Gestational age and mean birth weight had no effect on the rate of episiotomy (p value =0.57 and 0.30) and perineal tear (p value= 0.79 and 0.061). There was no mother-to-child HIV transmission. Episiotomies should be given when needed irrespective of HIV status because of the risk of consequent perineal tear and with HAART the risk of MTCT from perineal trauma is minimal. RésuméL'épisiotomie restrictive est recommandée pour la prévention de la transmission verticale du VIH. L'étude a comparé la fréquence d'utilisation de l'épisiotomie et l'apparition de larmes périnéales; et les facteurs connexes chez les femmes séropositives et séronégatives et pour évaluer leur effet sur la transmission de la mère à l'enfant (TME) du VIH. Au total, 110 parturientes séropositives et 134 parturientes séronégatives ont été incluses dans l'étude. L'incidence de l'épisiotomie était plus élevée dans le groupe séronégatif (p = 0,0000), alors que celle de la déchirure périnéale n'était pas affectée par le statut VIH (p = 0,17). Le taux d'épisiotomie était significativement affecté par la primigravité chez les sujets séronégatifs (OR = 0,032, IC 95% 0,0072-0,13). Le taux de déchirure périnéale était significativement affecté par la primigravité chez les sujets séropositifs (OR = 8,55, IC 95% 1,91-38,7) et la multigravidité chez les sujets seronégatifs (OR = 0,030, IC à 95% 0,71). L'âge gestationnel et le poids moyen à la naissance n'ont eu aucun effet sur le taux d'épisiotomie (valeur p = 0,57 et 0,30) et sur la déchirure périnéale (valeur p = 0,79 et 0,061). Il n'y avait pas de transmission du VIH de la mère à l'enfant. Des épisiotomies doivent être administrées au besoin, quel que soit l'état sérologique en raison du risque de déchirure périnéale qui en résulte et, en cas de multithérapie antirétrovirale, le risque de la TME dû à un traumatisme périnéal est minime. (Afr J Reprod Health 2017; 21[4]: 67-72).

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Section: Discussionmentioning

confidence: 99%

An Audit of Perineal Trauma and Vertical Transmisson Of HIV

Ocheke

Samuels

Ocheke

et al. 2017

Afr J Reprod Health

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“…There is evidence that episiotomies angled too close to the midline are at higher risk of causing OASI. The incidence of OASI in units that practise midline episiotomies is 7-20 % [19,64,71,72]. In a quasirandomised trial, Coats et al [73] found that 24 % of midline episiotomies in primiparous women were associated with OASIs in contrast to 2 % of mediolateral episiotomies.…”

Section: Angle Of the Episiotomymentioning

confidence: 99%

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

2015

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“…Several studies have compared episiotomies to an intact perineum or to spontaneous second degree lacerations in relation to pain perception (60,71,94,109), but very few studies have compared different episiotomy techniques (21,110,111). Prior to Paper I, no study had previously included the lateral technique in a comparative study.…”

Section: Perineal Painmentioning

confidence: 99%