open access

Vol 86, No 3 (2015)
ARTICLES
Get Citation

The role of episiotomy in prevention of genital lacerations during vaginal deliveries – results from two european centers

Antonio Simone Laganà, Milan M. Terzic, Jelena Dotlic, Emanuele Sturlese, Vittorio Palmara, Giovanni Retto, Dusica Kocijancic
DOI: 10.17772/gp/2058
·
Ginekol Pol 2015;86(3).

open access

Vol 86, No 3 (2015)
ARTICLES

Abstract

Objectives: There is an ongoing debate regarding the routine versus restrictive use of episiotomy. The study aim was to investigate if episiotomy during vaginal deliveries can reduce both, the number and severity of genital lacerations. Material and methods: The study included all women who gave vaginal birth at AOU. “G. Martino” Messina (n=382) and the Clinic for Ob/Gyn Clinical Center of Serbia, Belgrade (n=4221) during 2011. Lacerations during birth were recorded and divided according to location and severity. Women with lacerations were subdivided into two groups: with or without medio-lateral episiotomy. We assessed potential risk factors for laceration: maternal age, parity, use of labor stimulants and epidural analgesia, participation in antenatal classes, fetal presentation, neonatal birth weight, and duration of the second stage of labor. Results: Older women had higher grade perineum or combined lacerations. Children with higher birth weight in occipito-posterior presentation caused higher grade lacerations. Performance of episiotomy was connected with fewer perineum and labial lacerations. There were no differences in laceration grade between patients with and without episiotomy. Assessed parameters proved to be good discriminating factors between lacerations sites. According to logistic regression, laceration site was the most important risk factor for laceration grade. Combined lacerations had the highest grade. Conclusions: Episiotomy can significantly reduce the number of genital lacerations, but it does not influence laceration grade. Advanced maternal age, higher parity, occipito-posterior presentation and fetal macrosomia can cause lacerations during vaginal birth. Therefore, we suggest analysis of maternal and fetal factors to prevent widespread genital lacerations.

Abstract

Objectives: There is an ongoing debate regarding the routine versus restrictive use of episiotomy. The study aim was to investigate if episiotomy during vaginal deliveries can reduce both, the number and severity of genital lacerations. Material and methods: The study included all women who gave vaginal birth at AOU. “G. Martino” Messina (n=382) and the Clinic for Ob/Gyn Clinical Center of Serbia, Belgrade (n=4221) during 2011. Lacerations during birth were recorded and divided according to location and severity. Women with lacerations were subdivided into two groups: with or without medio-lateral episiotomy. We assessed potential risk factors for laceration: maternal age, parity, use of labor stimulants and epidural analgesia, participation in antenatal classes, fetal presentation, neonatal birth weight, and duration of the second stage of labor. Results: Older women had higher grade perineum or combined lacerations. Children with higher birth weight in occipito-posterior presentation caused higher grade lacerations. Performance of episiotomy was connected with fewer perineum and labial lacerations. There were no differences in laceration grade between patients with and without episiotomy. Assessed parameters proved to be good discriminating factors between lacerations sites. According to logistic regression, laceration site was the most important risk factor for laceration grade. Combined lacerations had the highest grade. Conclusions: Episiotomy can significantly reduce the number of genital lacerations, but it does not influence laceration grade. Advanced maternal age, higher parity, occipito-posterior presentation and fetal macrosomia can cause lacerations during vaginal birth. Therefore, we suggest analysis of maternal and fetal factors to prevent widespread genital lacerations.
Get Citation

Keywords

episiotomy / genital lacerations / vaginal delivery / laceration risk factors

About this article
Title

The role of episiotomy in prevention of genital lacerations during vaginal deliveries – results from two european centers

Journal

Ginekologia Polska

Issue

Vol 86, No 3 (2015)

DOI

10.17772/gp/2058

Bibliographic record

Ginekol Pol 2015;86(3).

Keywords

episiotomy / genital lacerations / vaginal delivery / laceration risk factors

Authors

Antonio Simone Laganà
Milan M. Terzic
Jelena Dotlic
Emanuele Sturlese
Vittorio Palmara
Giovanni Retto
Dusica Kocijancic

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl