Comparison of Perineal Lacerations in Routine vs. Selective Mediolateral Episiotomy among Women Referring to the Obstetrics Department of Besat Hospital in Sanandaj in 2011

Document Type : Original Article


1 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

2 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.

3 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

4 Assistant Professor, Department of Community Medicine, school of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

5 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.


Introduction: Perineal lacerations are common complications during childbirth and may occur spontaneously during this process. Midwives or obstetricians may need to make a surgical incision (episiotomy) to increase the diameter of the vaginal outlet and facilitate the neonate’s birth. The aim of this study was to compare perineal lacerations in routine versus selective episiotomy.
Methods: The current study was performed on 986 nulliparous women, admitted to Besat Hospital of Sanandaj in 2010-2011. Patients were randomly allocated to routine and selective episiotomy (only in case of vacuum-assisted delivery or fetal distress) groups. For data analysis, t-test, Chi-square, and Fisher's exact test were performed, using SPSS version 15. P-value less than 0.05 was considered statistically significant.
Results: duration of the second stage of labor, first-degree tears, and labia minora lacerations in selective episiotomy was significantly greater than the routine episiotomy group (P=0.0001). However, there was no significant difference between the two groups regarding second-, third-, or fourth-degree lacerations.
Conclusion: Routine mediolateral episiotomy could not prevent severe perineal lacerations but failure to do this in all cases (performed only in selected cases) resulted in first-degree lacerations and anterior perineal trauma. So it seems, limited use of episiotomy is a more rational approach for managing perineal outcomes during labor.


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