Does midline episiotomy increase the risk of third- and fourth-degree lacerations in operative vaginal deliveries?

To explore the association between midline episiotomy and the risk of third- and fourth-degree lacerations during operative vaginal delivery with either vacuum extractor or forceps. This retrospective cohort study analyzed all operative vaginal deliveries at a university hospital in 1989 and 1990. U...

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Bibliographic Details
Published inObstetrics and gynecology (New York. 1953) Vol. 82; no. 2; p. 276
Main Authors Helwig, J T, Thorp, Jr, J M, Bowes, Jr, W A
Format Journal Article
LanguageEnglish
Published United States 01.08.1993
Subjects
Birth Weight
Cohort Studies
Confounding Factors (Epidemiology)
Episiotomy - adverse effects
Episiotomy - methods
Female
Humans
Infant, Newborn
Obstetrical Forceps
Perineum - injuries
Pregnancy
Retrospective Studies
Risk Factors
Vacuum Extraction, Obstetrical
Wounds and Injuries - epidemiology
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Summary:To explore the association between midline episiotomy and the risk of third- and fourth-degree lacerations during operative vaginal delivery with either vacuum extractor or forceps. This retrospective cohort study analyzed all operative vaginal deliveries at a university hospital in 1989 and 1990. Univariate analysis of the relationships between perineal lacerations and obstetric variables was performed. Stratified analysis using the relevant variables was used to calculate relative risk (RR) estimates. Episiotomy, birth weight, and whether the index birth was the first vaginal birth were associated with third- and fourth-degree perineal lacerations. Stratified analysis demonstrated an RR of 2.4 with a 95% confidence interval of 1.7-3.5 for rectal injury with episiotomy, adjusting for parity and birth weight. Midline episiotomy is associated with an increased risk of third- and fourth-degree perineal lacerations in operative vaginal deliveries.
ISSN:0029-7844
1873-233X