The role of mediolateral episiotomy during operative vaginal delivery

Sultan, Abdul H.; Thakar, Ranee; Ismail, Khaled M.; Kališ, Vladimír; Laine, Katariina; Räisänen, Sari; Leeuw, J.W. de

doi:10.1016/j.ejogrb.2019.07.005

Cited by 53 publications

(49 citation statements)

References 27 publications

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“…The use of episiotomy to facilitate childbirth has long been part of the midwifery practice introduced by Dr. Joseph Lee more than a century ago [ 3 ]. Although episiotomy should be performed based on the judgment of the cause of labor if there is any indication, nevertheless, in many countries, episiotomy is performed routinely [ 4 ]. The prevalence of episiotomy in Iran is reported to be 41.5%, which is much higher than the WHO standard [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

Taleb

Saeedi

2021

BMC Complement Med Ther

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Background The pain and discomfort caused by episiotomy affect the quality of life of the mothers, so rapid and complete repair of the episiotomy is very important. Due to the effective ingredients of Verbascum Thapsus, it has been used since ancient times to treat wounds. Therefore, this study aimed to evaluate the effect of Verbascum Thapsus on episiotomy wound healing. Methods The study was designed as a randomized, double-blind, controlled clinical trial. Ninety-three primiparous women who were referred to Fatemeh Zahra Hospital in Saveh in 2015 were randomly divided into two groups of intervention (Verbascum Thapsus) and control (placebo). Both groups covered the episiotomy wound twice a day for 10 days with 2 cm of prescribed creams. Wound healing was assessed using the REEDA scale before the intervention and on days 1,3 and 10 after the intervention. Results Before the intervention, there was no statistically significant difference in terms of demographic characteristics, obstetrics, and REEDA scores between the two groups (p < 0.05). The mean scores of REEDA on days 1 and 3 in the intervention group were better than the control group but were not statistically significant. However, on the tenth day after the intervention, the mean scores of REEDA were significantly better in the Verbascum group than the placebo (p = 0.01). Conclusions According to the results of this study, it seems that Verbascum Thapsus is effective in repairing episiotomy wounds. The researchers hope that the results of this study can provide clinical evidence for the use of this herbal medicine in the wound healing process. Trial registration This study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code “IRCT201404073106N15” on 02/12/2015.

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Section: Introductionmentioning

confidence: 99%

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

Taleb

Saeedi

2021

BMC Complement Med Ther

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“…Data from several large observational and cohort studies conflict with the findings of randomised trials, and suggest that episiotomy reduces the incidence of OASI associated with operative vaginal deliveries . However, the potential for bias in these trials must be remembered.…”

Section: Discussionmentioning

confidence: 94%

Optimising non‐rotational forceps: the anterior ninety‐degree elevation forceps (ANEF) approach

Myriknas

Papadakis

Hinshaw

2020

The Obstetric & Gynaecologis

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“…6 Paule de Viguier Maternity, Toulouse University Hospital, Toulouse, France. 7 Caremeau University Hospital, Department of Obstetrics and Gynecology, Nimes, France. 8 Centre Hospitalier Départemental de La Roche sur Yon, Department of Obstetrics and Gynecology, La Roche sur Yon, France.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…There have been several risk factors reported for OASI occurrence, among which the most important are nulliparity and operative vaginal delivery, especially in case of forceps delivery [1][2][3][4]. When these two risk factors are associated, OASI prevalence ranging from 2 to 20% has been reported [5][6][7][8]. Even when such a high-risk situation is clearly identified, preventive strategies to avoid OASI occurrence remains disappointing.…”

Section: Introductionmentioning

confidence: 99%

A core outcome set development for a French national prospective study about the effect of mediolateral episiotomy on obstetric anal sphincter injury during operative vaginal delivery (INSTRUMODA)

Gachon

Schmitz

Parant

et al. 2021

BMC Pregnancy Childbirth

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Background We aimed at developing a core outcome and variables of interest set to investigate the effects of mediolateral episiotomy on Obstetric Anal Sphincter Injury (OASI) during and after operative delivery in nulliparous women in a large-scale one-year observational French study including 15,000 women (INSTRUMODA). Methods A list of outcomes and variables of interest was suggested to obstetricians participating in the INSTRUMODA study using online questionnaires divided into 7 categories: the woman’s history and course of pregnancy, course of labor, modalities of operative delivery, episiotomy characteristics, immediate maternal morbidity, one-year maternal morbidity, immediate neonatal morbidity. We used a three-round DELPHI method to reach a consensus. In the first round, outcomes and variables considered as essential by 70% or more of obstetricians were included in the corpus whereas they were excluded when 70% rated them as “not important”. In the second round, non-consensual outcomes and variables were reassessed and excluded or definitively included if considered as “not important” or essential by 50% or more of the obstetricians. During the first round, obstetricians were invited to suggest new outcomes and/or variables that were then assessed in the second and third round. We used the same method to develop a core outcome and variables of interest set in a population of women in the community recruited via an association of patients. At the end of the procedure the core outcome and variables of interest sets were merged to provide the final core outcome set for the INSTRUMODA study. Results Fifty-three obstetricians and 16 women filled out questionnaires. After the 3 rounds of Delphi procedure in each population, 74 outcomes and variables were consensually reported by obstetricians and 92 by women in the community. By mixing these two consensual corpora we reported a final consensual list of 114 variables of interest and outcomes for both obstetricians and women. Conclusion We established a core outcome and variables of interest set among obstetricians and women in the community to investigate the association between mediolateral episiotomy and OASI during operative delivery. Trial registration The INSTRUMODA study was registered on https://clinicaltrials.gov on June 25, 2020 (NCT04446780).

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The role of mediolateral episiotomy during operative vaginal delivery

Cited by 53 publications

References 27 publications

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

Optimising non‐rotational forceps: the anterior ninety‐degree elevation forceps (ANEF) approach

A core outcome set development for a French national prospective study about the effect of mediolateral episiotomy on obstetric anal sphincter injury during operative vaginal delivery (INSTRUMODA)

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