Commentary on Morbidity experienced by women before and after operative vaginal delivery: Prospective cohort study nested within a two-centre randomised controlled trial of restrictive versus routine use of episiotomy

摘要

Third- or fourth-degree lacerations are important obstetric complications to understand, for clinicians and researchers alike. These severe lacerations are associated with both fecal and flatal incontinence, chronic pain and dyspareunia. There is evidence to suggest that routine episiotomy at the time of operative vaginal delivery is associated with more third-and fourth-degree lacerations (Hartmann et al., JAMA 2005;293:2141-2148); however, when this evidence is dissected, the association appears to be with midline episiotomy as opposed to mediolateral episiotomy, which may actually be protective (Revicky et al., EJOG 2010;150:142-146).