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Use of Episiotomy in Obstetrical Care: A Systematic Review: Evidence Report/Technology Assessment
Meera Viswanathan (au)
Addresses 5 questions: (1) Does the practice of liberal or routine episiotomy, compared to more selective use of episiotomy, influence maternal postpartum outcomes (MPO)? (2) Does episiotomy incision type (i.e., midline or mediolateral), influence MPO? (3) Does the repair of the perineal defect (i.e., suture type & repair approach) influence MPO? (4) Does episiotomy have a long-term influence on urinary incontinence, fecal incontinence, or pelvic floor defects? & (5) Does episiotomy or incision type, or both, influence future sexual function? Immediate MPO from routine episiotomy are not better than those from restrictive use, but are worse because some proportion of women who would have had lesser injury instead had a surgical incision. Illus.
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