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Created on : 13 May 2004
Modified on : 01 Dec 2007

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Bibliographical entry (without author) :

Is routine use of episiotomy justified? American Journal of Obstetrics and Gynecology Volume 174(5) May 1996 pp 1399-1402

Author(s) :

Lede, Roberto L. MD, PhD; Belizan, Jose M. MD, PhD; Carroli, Guillermo MD

Year of publication :

1996

URL(s) :

http://www.gentlebirth.org/archives/episstdy.html

Résumé (français)  :

Abstract (English)  :

Episiotomy, one of the most common surgical procedures, was introduced in clinical practice in the eighteenth century without having strong scientific evidence of its benefits. Its use was justified by the prevention of severe perineal tears, better future sexual function, and a reduction of urine and fecal incontinence. With regard to the first assumption, the evidence that is based on five randomized controlled trials shows a 9% reduction in severe perineal tears in the selective use of episiotomy, but this effect fluctuates between a 40% reduction and a 38% increase. In relation to long-term effects, women in whom management includes routine use of episiotomy have shown poorer future sexual function, similar pelvic floor muscle strength, and similar urinary incontinence in comparison with women in whom episiotomy is used in a selective manner. In summary, there is no reliable evidence that routine use of episiotomy has any beneficial effect; on the contrary, there is clear evidence that it may cause harm such as a greater need for surgical repair and a poorer future sexual capability. In view of the available evidence the routine use of episiotomy should be abandoned and episiotomy rates 30% do not seem justified.

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Resumen (español)  :

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Argument (français) :

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Keywords :

➡ prevention ; episiotomy ; perineal/vaginal tears ; incontinence/prolapsus

Author of this record :

Bernard Bel — 13 May 2004
➡ latest update : Marion Corbe — 01 Dec 2007