Benefits and Risks of Episiotomy
Obstetrical & Gynecological SurveyPublished 1 November 1995
Robert J. Woolley
Citations62
SJR quartileQ2
SJR score0.57
SNIP1.41
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
Abstract
Part II continues a review of the literature on the benefits and risks of episiotomy published since 1980.
Keywords
Medicine
New England Journal of MedicineAnal-Sphincter Disruption during Vaginal Delivery
1,532 Citations1993Abdul H. Sultan, Michael A. Kamm +3 more
The LancetINJURY TO INNERVATION OF PELVIC FLOOR SPHINCTER MUSCULATURE IN CHILDBIRTH
851 Citations1984S. J. Snooks, Michael Swash +2 more
The results of the study suggest that in most cases this incontinence results from damage to the innervation of the pelvic floor muscles.
BJOG An International Journal of Obstetrics & GynaecologyPelvic floor damage and childbirth: a neurophysiological study
810 Citations1990Ruth E. Allen, Gordon Hosker +2 more
It is concluded that vaginal delivery causes partial denervation of the pelvic floor (with consequent re‐innervation) in most women having their first baby.
BMJThird degree obstetric anal sphincter tears: risk factors and outcome of primary repair
766 Citations1994Abdul H. Sultan, Michael A. Kamm +2 more
Vacuum, extraction is associated with fewer third degree tears than forceps delivery and an episiotomy does not always prevent a third degree tear, according to retrospective analysis of obstetric variables.
British journal of surgeryEffect of vaginal delivery on the pelvic floor: A 5-year follow-up
614 Citations1990S. J. Snooks, Michael Swash +2 more
Evidence is provided for the hypothesis that pudendal neuropathy due to vaginal delivery persists and may worsen with time and for the effect of childbirth on the pelvic floor striated sphincter musculature.
BirthExpectations, Experiences, and Psychological Outcomes of Childbirth: A Prospective Study of 825 Women
481 Citations1990Josephine M. Green, Vanessa A. Coupland +1 more
High expectations were not found to be bad for women, although low expectations often were, and information and feeling in control were consistently associated with positive psychological outcomes.
BJOG An International Journal of Obstetrics & GynaecologyThe role of partial denervation of the pelvic floor in the aetiology of genitourinary prolapse and stress incontinence of urine. A neurophysiological study
453 Citations1989Anthony Smith, Gordon Hosker +1 more
The results suggest that partial denervation of the pelvic floor with subsequent reinnervation is a normal accompaniment of ageing and is increased by childbirth.
Obstetrical & Gynecological SurveyBenefits and Risks of Episiotomy
436 Citations1983STEPHEN B. THACKER, H. DAVID BANTA
There is evidence that postpartum pain and discomfort are accentuated after episiotomy, and serious complications, including maternal death, can be associated with the procedure, so carefully designed controlled trials of benefit and risk should be carried out on the use of Episiotomy.
BJOG An International Journal of Obstetrics & GynaecologyPudendal nerve damage during labour: prospective study before and after childbirth*
432 Citations1994Abdul H. Sultan, Michael A. Kamm +1 more
The effect of childbirth on pudendal nerve function is established and obstetric factors associated with such damage are identified.
BMJWest Berkshire perineal management trial.
428 Citations1984Jennifer Sleep, Adrian Grant +4 more
Findings provide little support either for liberal use of episiotomy or for claims that reduced use of the operation decreases postpartum morbidity.
The LancetRisk factors for mother-to-child transmission of HIV-1
422 Citations1992European Collaborative Study
The balance of evidence suggests that mothers with established infection can transmit HIV infection through breastmilk, although the relative importance of this route remains to be defined.
International Journal of Colorectal DiseaseRisk factors in childbirth causing damage to the pelvic floor innervation
419 Citations1986S. J. Snooks, Michael Swash +2 more
Analysis of the whole group of 122 women showed that multiparity, forceps delivery, increased duration of the second stage of labour, third degree perineal tear and high birth weight were important factors leading to pudendal nerve damage.
American Journal of Obstetrics and GynecologyRelationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation
417 Citations1994Michael Klein, Robert Gauthier +10 more
Perineal and pelvic floor morbidity was greatest among women receiving median episiotomy versus those remaining intact or sustaining spontaneous perineal tears, and Episiotomy use should be restricted to specified fetal-maternal indications.
Obstetrics and GynecologyOn protection of the maternal perineum during birth
383 Citations1983Robert C. Goodlin
The author's experience and a review of the medical literature suggest that prophylactic episiotomy is not indicated.
American Journal of Obstetrics and GynecologyShoulder dystocia: An analysis of risks and obstetric maneuvers
269 Citations1993James J. Nocon, D. McKenzie +2 more
Most of the traditional risk factors for shoulder dystocia have no predictive value, shoulder dyStocia itself is an unpredictable event, and infants at risk for permanent injury are virtually impossible to predict.
BJOG An International Journal of Obstetrics & GynaecologyThe role of pudendal nerve damage in the aetiology of genuine stress incontinence in women
261 Citations1989Anthony Smith, Gordon Hosker +1 more
Conduction was studied in the terminal branches of the pudendal nerve in 42 women with normal urinary control and 87 women with stress incontinence of urine, genitourinary prolapse, or both, showing clear evidence of denervation damage to the pelvic floor.
European Journal of Obstetrics & Gynecology and Reproductive BiologyRisk factors for major obstetric haemorrhage
253 Citations1993William Stones, CATHERINE M. PATERSON +1 more
The hazards of well known factors such as multiple pregnancy, abruption, placenta praevia and caesarean delivery were confirmed but attention is drawn to the potential risk of haemorrhage associated with obesity or a large baby and to that associated with retained Placenta in women classified as 'low risk'.
British Journal of UrologyPerineal Nerve Damage in Genuine Stress Urinary Incontinence; An Electrophysiological Study
227 Citations1985S. J. Snooks, D. F. BADENOCH +2 more
Patients with genuine stress incontinence of urine were shown to have slowed conduction in the perineal branch of the pudendal nerve which innervates the periurethral striated sphincter muscle which may have implications regarding selection of patients for surgery to restore urethral competence.
BMJWest Berkshire perineal management trial: three year follow up.
204 Citations1987Jennifer Sleep, Adrian Grant
Women who had participated in a randomised controlled trial of policies of restricted (10%) versus liberal (51%) episiotomy during spontaneous vaginal delivery were recontacted by postal questionnaire three years after delivery, and there was no evidence of a differential response rate between the two trial groups.
European Journal of Obstetrics & Gynecology and Reproductive BiologyDiscrepancy between laboratory determination and visual estimation of blood loss during normal delivery
202 Citations1991S. J. Duthie, Dip Ven +4 more
Findings show that visual estimation of blood loss was grossly inaccurate and the size of the discrepancy between measured and estimatedBlood loss was proportional to the measured blood loss.
American Journal of Obstetrics and GynecologyRisk factors for third-degree and fourth-degree perineal lacerations in forceps and vacuum deliveries
197 Citations1990C. Andrew Combs, Patricia A. Robertson +1 more
Factors associated with increased risk for third- and fourth-degree lacerations were midline episiotomy, nulliparity, second-stage arrest, occipitoposterior position, low or mid station, use of forceps instead of vacuum,Use of local anesthesia, and Asian race.
New England Journal of MedicineThe Ethics of the Randomized Clinical Trial
193 Citations1982Arthur Schafer
Some of the major ethical problems posed by the randomized clinical trial are distinguished, to set out some of the principal considerations.
Acta Obstetricia Et Gynecologica ScandinavicaIntra‐ and inter‐observer variability in the assessment of intrapartum cardiotocograms
192 Citations1987Pernille Nielsen, Bjarne Stigsby +2 more
The considerable observer variability found in this and other investigations must severely impair the clinical value of electronic fetal monitoring (EFM) and the variability must be reduced before the “true” predictive value and the cost/benefit of EFM can be estimated.
BJOG An International Journal of Obstetrics & GynaecologyFaecal incontinence due to external anal sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature: a double pathology
189 Citations1985S. J. Snooks, M M Henry +1 more
This finding suggests that damage to the innervation of the external anal sphincter often co‐exists with direct injury to the muscle; in these patients pelvic floor surgery may be required, in addition to spHincter repair itself.
Journal of the Royal Society of MedicineUnifying Concept of Pelvic Floor Disorders and Incontinence
181 Citations1985Michael Swash, M M Henry +1 more
Diseases of the Colon & RectumAnorectal complications of vaginal delivery
178 Citations1989K. S. Venkatesh, P. S. Ramanujam +2 more
The incidence of anorectal complications following vaginal delivery was studied in 20,500 women and surgical correction of these complications resulted in satisfactory outcome.
British journal of surgeryDelayed external sphincter repair for obstetric tear
177 Citations1988Søren Laurberg, Michael Swash +1 more
The functional result of delayed anal sphincter repair after obstetric lesions is partly dependent upon whether the nerve supply is intact, and pre‐operative physiological evaluation can give information on the probability of a successful surgical result.
BJOG An International Journal of Obstetrics & GynaecologyRisks of anal incontinence from subsequent vaginal delivery after a complete obstetric anal sphincter tear
176 Citations1992Karl Möller Bek, Søren Laurberg
This study aims to assess the influence of various risk factors on long term anal incontinence in women with a complete obstetric tear of the anal sphincter.
European Journal of Obstetrics & Gynecology and Reproductive BiologyLong-term ailments due to anal sphincter rupture caused by delivery — a hidden problem
170 Citations1988Knut Haadem, Sten Ohrlander +1 more
Primiparity, instrumental deliveries, abnormal presentation, large babies and oxytocin stimulation were all risk factors for anal sphincter ruptures, and long-term symptoms occurred in 7 (88%) of women with ASR also involving the anal mucosa, but only in 21 (39%) of those with AsR only.
The LancetRoutine vs selective episiotomy: a randomised controlled trial
166 Citations1993
Selective with routine use of a mediolateral episiotomy for women having first and second deliveries in 8 public maternity units in Argentina and the main outcome measure was severe perineal trauma is compared.
MidwiferyThe ‘Know Your Midwife’ scheme—a randomised trial of continuity of care by a team of midwives
163 Citations1989C Flint, Polly Poulengeris +1 more
A team of four midwives provided the majority of care during pregnancy, labour and the puerperium to 503 women at low obstetric risk, over a 2-year period, associated with greater continuity in all phases of maternity care.
BJOG An International Journal of Obstetrics & GynaecologyPostpartum haemorrhage—a continuing problem
149 Citations1987Lisa Gilbert, W Porter +1 more
Epi‐dural analgesia contributed indirectly to an increase in the risk of postpartum haemorrhage and the changes in labour ward practice over the last 20 years have resulted in the re‐emergence of PPH as a significant problem.
Obstetrics and GynecologyIncontinence Following Rupture of the Anal Sphincter During Delivery
144 Citations1993LISA A. CRAWFORD, ELISABETH H. QUINT +2 more
Incontinence of flatus was reported six times more often by women who experienced a third‐ or fourth‐degree perineal laceration than by those without anal sphincter rupture.
European Journal of Obstetrics & Gynecology and Reproductive BiologyIncidence and cause of postpartum urinary stress incontinence
139 Citations1992Th. Dimpfl, U. Hesse +1 more
It can be said, that vaginal delivery itself predisposes for permanent stress urinary incontinence (SUI).
American Journal of Obstetrics and GynecologyInterobserver and intraobserver variation in the assessment of antepartum cardiotocograms
135 Citations1982F.K. Lotgering, Henk C.S. Wallenburg +1 more
A low level of agreement between observers was shown to exist for all three systems tested, and the level of intraobserver agreement was shows to be much higher for virtually all three Systems.
BJOG An International Journal of Obstetrics & GynaecologyNeonatal and maternal morbidity in relation to the length of the second stage of labour
135 Citations1992NIGEL ST. G. SAUNDERS, CATHERINE M. PATERSON +1 more
Investigation of the relation between the duration of the second stage of labour and subsequent early neonatal and maternal morbidity in women during labour and thereafter finds no link between duration and morbidity.
American Journal of Obstetrics and GynecologyThe urethral pressure profile in pregnancy and after delivery in healthy nulliparous women
133 Citations1982J. M. van Geelen, W.A.J.G. Lemmens +2 more
Observations suggest that an inherent weakness of the urethral sphincter mechanism plays a key role in the pathogenesis of stress incontinence during pregnancy and/or after delivery.
Gynecologic OncologyClear cell carcinoma arising in extraovarian endometriosis: Report of three cases and review of the literature
131 Citations1990Ibrahim F. Hitti, Sidney S. Glasberg +1 more
BMJIs routine episiotomy necessary?
131 Citations1984Robert F. Harrison, M Brennan +3 more
The value of routine episiotomy in primigravid patients is questioned, but the final decision can be made only by the accoucheur at the time of imminent delivery.
BirthThe Components of Women's Satisfaction with Maternity Care
120 Citations1989Louise Séguin, Rita Therrien +2 more
Items relative to the delivery process such as pain intensity, complications, and length of labor were the most important for the delivery experience itself and participation in the decision-making process was the first component of satisfaction with medical care.
The American Journal of SurgeryManometric diagnosis of anal sphincter injuries
112 Citations1990Richard E. Perry, Garnet J. Blatchford +3 more
It is concluded that the vector symmetry index can expose occult anal sphincter injuries and may have a role in the selection of patients for spHincter repair.
American Journal of Obstetrics and GynecologyCorrelation of neonatal acid-base status with Apgar scores and fetal heart rate tracings
109 Citations1986F. Page, James N. Martin +6 more
The investigations suggest that the combination of fetal heart rate monitoring, cord blood pH, and Apgar assessment is better than any one parameter alone as an evaluation of fetal status just after delivery.
BMJ"Primum non nocere" and the principle of non-maleficence.
107 Citations1985R Gillon
Gillon argues that risking harm is often necessary to obtain therapeutic benefit, and that always giving nonmaleficence priority over beneficence in clinical decision making results in "therapeutic nihilism."
Gynecologic and Obstetric InvestigationAdvantage or Disadvantage of Episiotomy Compared with Spontaneous Perineal Laceration
96 Citations2010Per‐Göran Larsson, Jens‐Jörgen Platz‐Christensen +2 more
The results indicate that many women will unnecessarily suffer after an episiotomy, and the patient's subjective problems are significantly increased, both immediately and at the 3-month postoperative follow-up.
European Journal of Obstetrics & Gynecology and Reproductive BiologyAnal sphincter function after delivery: a prospective study in women with sphincter rupture and controls
92 Citations1990Knut Haadem, Jan Anders Dahlström +1 more
A significantly increased frequency of gas incontinence was found in the women with anal sphincter rupture, however, a significantly increased number of patients after 12 months.
JAMAAssessing the quality of randomization from reports of controlled trials published in obstetrics and gynecology journals
92 Citations1994Kenneth F. Schulz
BirthScientific Inquiry and Authoritarianism in Perinatal Care and Education
90 Citations1983lain Chalmers
This tension needs greater public exposure and discussion than it has received because the scientific method offers an efficient framework within which to protect families from the unintended adverse consequences of authoritarian prescriptions and proscriptions in perinatal care and education.
Acta Obstetricia Et Gynecologica ScandinavicaIntervention during labor: risk factors associated with complete tear of the anal sphincter
85 Citations1992Karl Möller Bek, Søren Laurberg
Among 41,200 consecutive deliveries there were 152 cases of complete tear of the anal sphincter (complete tear) and the association between interventions during labor and complete tear was evaluated by confounder control using multiple logistic regression analysis.
BJOG An International Journal of Obstetrics & GynaecologyTRAUMATIC INTRACRANIAL HAEMORRHAGE IN FIRSTBORN INFANTS AND DELIVERY WITH OBSTETRIC FORCEPS
83 Citations1981Kieran O’Driscoll, Declan Meagher +2 more
The main conclusion is that serious injury to the forecoming head at birth is almost invariably a direct effect of forceps.
BJOG An International Journal of Obstetrics & GynaecologyEpisiotomy and perineal lesions in spontaneous vaginal deliveries
82 Citations1992Tine Brink Henriksen, Karl Möller Bek +2 more
The influence of mediolateral episiotomy on the perineal state after spontaneous, singleton vaginal deliveries with fetus in the occiput anterior position is evaluated.
American Journal of Obstetrics and GynecologyAssociation of episiotomy and delivery position with deepperineal laceration during spontaneous delivery in nulliparous women
79 Citations1989Lynn Borgatta, Susan L. Piening +1 more
The results suggest that selective use of episiotomy and stirrups can minimize perineal trauma during spontaneous delivery in nulliparous women.
American Journal of Obstetrics and GynecologyEpisiotomy: Can its routine use be defended?
76 Citations1989John M. Thorp, Watson Bowes
A careful review finds little evidence to support the argument that episiotomy reduces perineal trauma and prevents subsequent pelvic relaxation, and may predispose the gravid woman to third- and fourth-degree lacerations.
Acta Obstetricia Et Gynecologica ScandinavicaThe effect of mediolateral episiotomy at delivery on pelvic floor muscle strength evaluated with vaginal cones
70 Citations1991Gunny Röckner, Aino Fianu Jonasson +1 more
BJOG An International Journal of Obstetrics & GynaecologyMothers', midwives' and obstetricians' views on the features of obstetric care which influence satisfaction with childbirth
66 Citations1989Natalie Drew, Peter Salmon +1 more
There was no evidence that midwives perceived patients’ needs more accurately than did the obstetricians, and variations between the three groups’ ranking of specific items may reflect the defence of their respective roles by each profession.
BJOG An International Journal of Obstetrics & GynaecologyEpisiotomy and third‐degree tears
66 Citations1985Pierre Buekens, RAPHAEäL LAGASSE +2 more
No relation between episiotomy and third‐degree tear was found and to avoid the effect of confounding factors, a sub‐sample was analysed that included only vertex presentations with spontaneous occipitoanterior vaginal deliveries.
The LancetPERINEAL MUSCLE FUNCTION AFTER CHILDBIRTH
66 Citations1985H. Gordon
The efficiency of the perineal muscles was found to be significantly related to the extent to which women took regular exercise, and it was found that the level of exercise women took after childbirth affected muscle function.
BirthSocial Consequences of Obstetric Technology: the Importance of Measuring “Soft” Outcomes
63 Citations1983Ann Oakley
The impact of obstetric technology on the outcome of pregnancy has been evaluated by three main categories of outcome measures-those to do with mortality, physical morbidity, and “psychosocial” morbidity.
BirthOutcomes and Procedures in Low Risk Birth: A Comparison of Hospital and Birth Center Settings
61 Citations1987Elizabeth Feldman, Marsha Hurst
Findings are consistent with studies of other settings in which the place of birth was shown to have an impact on childbirth experience, thus demonstrating that birth centers can oversee childbirth as safely and with less intervention than do hospitals.
Diseases of the Colon & RectumAnal incontinence following obstetrical injury
60 Citations1985Marvin L. Corman
The operative approach and results indicate that excellent function can be achieved by recognition of the deformity and by the appropriate repair.
The Medical Journal of AustraliaRecovery after childbirth: a preliminary prospective study
59 Citations1990Suzanne Abraham, Jeannette Vizzard +3 more
Factors that were associated with discomfort for longer than the median time were delivery by forceps; spontaneous vaginal (not perineal) tears; and, in the three to four days after the birth, oedema and the breakdown of muscle or skin sutures.
BJOG An International Journal of Obstetrics & GynaecologyEpisiotomy repair—immediate and long‐term sequelae. A prospective randomized study of three different methods of repair
58 Citations1986L. ISAGER‐SALLY, Jesper Legarth +2 more
It is concluded that the subcuticular technique using polyglycolic acid should be the method of choice for episiotomy repair and the group treated with method 3 had the best long‐term results.
Journal of Nurse-MidwiferyThe National Birth Center Study Part II—Intrapartum and immediate postpartum and neonatal care
56 Citations1992Judith P. Rooks, Norman L. Weatherby +1 more
Nulliparity was strongly associated with longer first stage labors and longer labor was associated with more frequent use of many kinds of interventions, and more macrosomic babies than among all U.S. births during the same time period.
American Journal of Obstetrics and GynecologyThe prediction of intrapartum fetal metabolic acidosis by fetal heart rate monitoring
56 Citations1981James A. Low, Martha J. Cox +4 more
Fetal heart rate characteristics during the 8 hours prior to delivery have been studied in 200 patients in whom the fetus had evidence of a metabolic acidosis at delivery, and compared to those in 200 Patients in whomThe fetus had a normal acid-base at delivery.
Nursing ResearchDigital Measurement of Pelvic Muscle Strength In Childbearing Women
55 Citations1989Carolyn M. Sampselle, Carol A. Brink +1 more
Validity was demonstrated in a pattern of lower scores in women who had urine loss during coughing or reported incontinence as compared with those who did not, and Women who had cesarean births had higher postpartum pelvic muscle scores.
Journal of Nurse-MidwiferyPsychometric properties of the REEDA
53 Citations1990P HILL
There are serious limitations with the REEDA tool when used for either clinical or research purposes, and the instrument was tested in a single postpartum hospital setting.
BirthA Controlled Study of the Effect of Prepared Childbirth Classes on Obstetric Outcomes
52 Citations1990Susan E. Hetherington
Despite the increased pushing ability of the class attenders, over 80 percent of women in both groups had an episiotomy, which was, in turn, significantly associated with a second-, third-, or fourth-degree laceration, thus bringing into question its routine use.
American Journal of Obstetrics and GynecologyEpisiotomy and its role in the incidence of perineal lacerations in a maternity center and a tertiary hospital obstetric service
47 Citations1989Lynne S. Wilcox, Donna M. Strobino +2 more
Use of an episiotomy was associated with a decrease in perineal lacerations of first- or second-degree, but a fourfold increase in the incidence of third-degree laceration.
Diseases of the Colon & RectumMedical malpractice involving colon and rectal disease
47 Citations1993Kenneth A. Kern
To determine objectively the causes of malpractice litigation involving colon and rectal disease, a retrospective review was undertaken of all cases tried in the U.S. federal and state civil court system over a 21-year period from 1971 through 1991, involving 103 allegations of negligence.
American Journal of Obstetrics and GynecologyThe paradox of electronic fetal monitoring: More data may not enable us to predict or prevent infant neurologic morbidity
46 Citations1993Mortimer G. Rosen, Janet C. Dickinson
Electronic fetal heart rate monitoring has been used to identify periods of fetal risk, with the hope that clinical intervention would avoid the potential for perinatal death or neurologic damage.
Gynecologic OncologyCarcinoma in episiotomy scars
46 Citations1992Peter A. van Dam, L. M. Irvine +4 more
The cases exemplify the need for careful inspection and biopsy of any nodular lesions in episiotomy scars as part of the initial assessment and follow-up of patients with premalignant or malignant lesions of the lower genital tract.
MidwiferyWomen's preferences for and satisfaction with current procedures in childbirth—findings from a national study
46 Citations1987Ann Jacoby
A random sample of women who had recently given birth were asked about their preferences in relation to a number of obstetric procedures, and generally women said they preferred not to have them.
Acta Obstetricia Et Gynecologica ScandinavicaSevere lacerations after childbirth
44 Citations1993Knut Hordnes, Per Bergsjø
Suggestions of delivery procedures aiming to reduce the extent of perineal trauma are given and the long term sequelae of severe lacerations are clearly underestimated.
Archives of Sexual BehaviorSexual function during the puerperium
43 Citations1984J. G. Grudzinskas, Linda E. Atkinson
Of 328 women interviewed at a postnatal clinic, 166 (50.6%) had resumed sexual intercourse, the average interval after delivery being 5 weeks postpartum, and of the sexually active group, 89% were practicing effective contraception.
Scandinavian Journal of Caring SciencesUrinary Incontinence after Perineal Trauma at Childbirth
43 Citations1990Gunny Röckner
Urinary incontinence symptoms were found in 65 women (36%).
Journal of Obstetrics and GynaecologyEpisiotomy and the perineum: a random controlled trial
43 Citations1986Michael J. House, G Cario +1 more
Symptoms on the 3rd day postpartum were, on average, reduced in the patients in whom the use of episiotomy was restricted.
Nursing ResearchDevelopment and Testing Of the Circumvaginal Muscles Rating Scale
42 Citations1986AMY MUR WORTH, Molly C. Dougherty +1 more
The purpose of this research was to develop an instrument for clinical assessment of the circumvaginal muscles (CVM), to test the reliability of the instrument, and to correlate sample characteristics with this instrument.
BirthThe Risks and Benefits of Episiotomy: A Review
42 Citations1982David Banta, Stephen B. Thacker
The literature does not support its routine use, since it is associated with significant risks of pain and infection, and the benefits claimed for routine episiotomy have not been subjected to randomized controlled trials.
BJOG An International Journal of Obstetrics & GynaecologyThe effect of vaginal delivery on the urethral sphincter
41 Citations1988A Tapp, LINDA CARDOZO +3 more
The group with competent urethral sphincter mechanisms did show some evidence to implicate an increased number of vaginal deliveries in poor function of the distal part of the urethralspine mechanism.
Acta Obstetricia Et Gynecologica ScandinavicaPostpartum Symptoms: Episiotomy Or Tear At Vaginal Delivery
38 Citations1990Ingrid Thranov, Anne Mette Kringelbach +3 more
Postpartum perineal pain symptoms were significantly correlated to the duration of the second stage of labor, irrespective of the episiotomy rate of the midwife in charge, or of the use of episiotome.
American Journal of Public HealthA study of pregnancy outcomes in a maternity center and a tertiary care hospital.
38 Citations1984Gigliola Baruffi, Woodrow S. Dellinger +4 more
Care delivered at BMC is safe with regard to the evaluative criteria used, and differences between the institutions were found mainly among women with low intrapartum risk.
Journal of Advanced NursingEpisiotomy and perineal trauma during childbirth
31 Citations1989Gunny Röckner, Vivian Wahlberg +1 more
It is concluded that there is little support for the claim that episiotomy prevents tears in normal deliveries, and that the rationale for the practice of episiotome is in need of reappraisal.
Journal of Nurse-MidwiferyComparison between different perineal outcomes on tissue healing
30 Citations1991Myra B. McGuinness, Kathleen F. Norr
BJOG An International Journal of Obstetrics & GynaecologyMIDLINE EPISIOTOMY AS A ROUTINE PROCEDURE
29 Citations1974Constance L. Beynon
The results of 1166 consecutive midline episiotomies in primigravidae who were delivered in one unit are presented and compared with other published surveys and the belief that extensions involving the rectum are a disaster is questioned.
Scandinavian Journal of Caring SciencesEvaluation of Episiotomy and Spontaneous Tears of Perineum during Childbirth
27 Citations1988Gunny Röckner, A. Henningsson +2 more
Episiotomy is a common operation during delivery little is known of its benefits compared with spontaneous tears but delayed healing was recorded for the episiotomy group and more analgesia was used post-partum by women with episiotomies.
Journal of Obstetric, Gynecologic & Neonatal NursingThe Dynamic Characteristics of the Circumvaginal Muscles
26 Citations1988Julie T. Samples, Molly C. Dougherty +2 more
Duncan's multiple range test showed differences in the maximum pressures between groups and indicated that vaginal birth has a marked weakening effect on the circumvaginal muscles.
Diseases of the Colon & RectumEndometriosis in episiotomy scar with anal sphincter involvement
24 Citations1991Joel Sayfan, Lea Benosh +2 more
It is suggested that this treatment policy should be recommended for these cases of endometriosis in an episiotomy scar with involvement of the external anal sphincter.
Journal of Nurse-MidwiferyA retrospective comparison of certified nurse-midwife and physician management of low risk births A pilot study
24 Citations1987F MAYES, Deborah Oakley +4 more
Results indicated that there were no differences in complications, but that very different care practices were experienced by clients of the two types of providers.
BJOG An International Journal of Obstetrics & GynaecologyIs end‐stage deceleration of the fetal heart ominous?
24 Citations1982Miriam Katz, NAFTALI SHANI +2 more
End‐stage deceleration (ESD) defined as deep and sustained fetal bradycardia during the second stage of labour was observed in 55 patients and 49 babies were born in excellent condition, although when ESD persisted for more than 15 min umbilical‐vein pH decreased.
Southern Medical JournalBlood Loss at Vaginal Delivery
23 Citations1986Joseph A. Hill, Hossam E. Fadel +3 more
This work presents a simple, practical, and convenient method of quantitating blood loss at vaginal delivery, and states that the method of vaginal delivery does not significantly affect blood loss; an episiotomy, a laceration, or both may.
Acta Obstetricia Et Gynecologica ScandinavicaThe use of episiotomy in primiparas in Sweden: A descriptive study with particular focus on two hospitals
20 Citations1991Gunny Röckner, Anders Ölund
Examining the use of episiotomy in primiparas on all labor wards in Sweden, focusing on two hospitals in particular, found a wide variation from hospital to hospital.
International Journal of Gynecology & ObstetricsPerineal endometriosis
19 Citations1990E Salamalekis, T X Vasiliadis +2 more
Four patients who developed endometriosis at the episiotomy scar are reported and three of them experienced cyclic pain at the site of the lesion during their menses and one patient had bloody discharge from the scar during menstruation.
Journal of NeurologyPreeclampsia complicated by cerebral hemorrhage and brain abscess
19 Citations1985José Biller, Harold P. Adams +2 more
A 34-year-old, preeclamptic woman developed a right basal ganglia hematoma during a vaginal delivery that was later complicated by an infected episiotomy, developing into a brain abscess.
Gynecologic OncologyGranular Cell Tumor of Vulva on Episiotomy Scar
18 Citations1994José Murcia, Miguel Á. Idoate +2 more
The granular cell tumor (GCT) is a rare neoplasm derived from Schwann cells and is considered to be a benign tumor and should be considered in the differential diagnosis of a benign tumors of the vulva and reactive granularcell lesions.
Journal of Nurse-MidwiferyCharacteristics associated with perineal condition in an alternative birth center
18 Citations1984Kevin Dunne
Neither the women who delivered without an episiotomy nor their infants appeared to suffer from the experience, and the majority of the population delivered over intact perineums.
BirthOutcomes of the First 527 Births at The Birthplace in Seattle
18 Citations1982Carla Reinke
Of 385 women cared for at The Birthplace through the onset of labor, 82 were transported to hospitals during labor, most for failure to progress before and after rupture of membranes and prolonged second stage.
BirthHow Can we Translate Good Science into Good Perinatal Care?
16 Citations1986David A. Grimes
Scientific skepticism, known more formally as the discipline of epidemiology, can help overcome five obstacles that impede perinatal care: seduction by authority, the false idol of technology, letting sleeping dogmas lie, the pursuit of pedantry, and numerators in search of denominators.
JAMAThe effect of type of delivery on neonatal outcome in singleton infants of birth weight of 1,000 g or less
13 Citations1983J. M. Barrett
Journal of Nurse-MidwiferyManagement of anticipated and actual shoulder dystocia Interpreting the literature
11 Citations1994Dominic Piper, Paul G. McDonald
A literature review of related professional disciplines was undertaken to study conflicts and identify support for applying a philosophy of minimal, appropriate intervention to the complex issue of shoulder dystocia.
Geburtshilfe und FrauenheilkundeBeschwerden infolge Episiotomie
11 Citations1983J. Matthias Wenderlein, E. Merkle
In 413 women following normal spontaneous delivery the short and long term complaints due to the episiotomy were studied and every fifth woman though that her vagina and perineum was disfigured by the episiotsomy scar.
…