Best approach to episiotomy unclear

NEW YORK (Reuters Health) - A pilot study of routine versus restrictive use of episiotomy during operative vaginal delivery has not provided conclusive evidence for the superiority of either approach, Irish and UK researchers report.

Operative vaginal delivery refers to a delivery in which the obstetrician uses forceps or a vacuum device to assist the woman in delivering her baby. Traditionally, episiotomy — an incision of the perineum intended to prevent tearing during the delivery of the baby –has been routine when operative vaginal delivery is required.

However, despite no rigorous formal evaluation, an increasing number of obstetricians are using the approach in a restrictive manner, i.e., only if tearing becomes apparent, according to Dr. D. J. Murphy of the University of Dublin and colleagues.

To compare the two strategies, they randomized 200 women who required operative vaginal delivery to routine or restrictive use of episiotomy.

There were no striking outcome differences between the routine or restrictive groups. Anal tears were seen in 8.1 percent of the routine group and 10.9 percent of the restrictive group.

Primary and postpartum bleeding occurred in 36.4 percent of women in the routine group and 26.7 percent of women in the restrictive group. For neonatal trauma, the rates were 45.5 percent and 43.6 percent, respectively.

The incidence of urinary and fecal incontinence, perineal infection and a prolonged hospital stay were also similar.

Overall, say the investigators, “The results are compatible with both clinically significant benefits and harms from routine episiotomy.”

SOURCE: BJOG (British Journal of Obstetrics and Gynecology, December 2008.

Source

--------------------------------------------------------------------------------------------
Related Posts:


NEW YORK (Reuters Health) - Pregnant women are more willing to accept potential risks of delivering their baby vaginally than are the medical professionals caring for them, Australian researchers report. And among the health care workers surveyed, midwives were ready to take the greatest risks, while colorectal surgeons and urogynecologists — the medical professionals involved in

Full Post: Women more willing than docs to accept labor risks
--------------------------------------------------------------------------------------------

NEW YORK (Reuters Health) - The odds are high that a woman who is prescribed an “anticholinergic” drug to relieve urinary incontinence or other lower urinary tract symptom will discontinue the medication not long after starting it, a study suggests. This is true regardless of the class of medication used. Two examples of anticholinergic drugs that

Full Post: Drug adherence poor in women with urinary trouble
--------------------------------------------------------------------------------------------

NEW YORK (Reuters Health) - The results of a mammographic screening study suggest that some invasive breast cancers may spontaneously regress over time. These findings “provide new insight on what is arguably the major harm associated with mammographic screening, namely, the detection and treatment of cancers that would otherwise regress,” Dr. H. Gilbert Welch, from the

Full Post: Some breast cancers may spontaneously disappear
--------------------------------------------------------------------------------------------

By Anthony J. Brown, MD NEW YORK (Reuters Health) - Nearly one third of people who suffer severe injuries are likely to have sexual problems a year later, according to findings recently presented at the meeting of the American College of Surgeons. “Previous studies have shown that men and women who sustain pelvic fractures and spinal cord

Full Post: Sexual difficulties common after major trauma
--------------------------------------------------------------------------------------------

By David Douglas NEW YORK (Reuters Health) - Perinatal mortality risk is increased in mothers with psychiatric disorders, and in their offspring as well, UK and Danish researchers report in an advance online publication by the Archives of Disease in Childhood–Fetal and Neonatal Edition. As senior investigator Dr. Kathryn M. Abel told Reuters Health, “A history of

Full Post: Maternal mental illness tied to perinatal deaths

Site Navigation

Most Read

Search