Review Shows No Benefit for Routine Episiotomy
Reuters Health
By Anthony J. Brown, MD
Wednesday, May 4, 2005
NEW YORK (Reuters Health) - Episiotomy, the incision used to widen the vaginal opening during delivery, should not be performed on a routine basis, according to a review of studies looking at this issue. Pregnant women treated with routine episiotomy do not fare better than other women plus they now have an incision that must heal.
Routine cutting of the vaginal opening was thought to make passage of the baby easier and prevent tears in the skin. Many believed this would promote better wound healing in the short term and reduce the risk of urinary or stool incontinence in the long term. However, the current findings provide no evidence to support any of these benefits.
The results reinforce the position held by the American College of Obstetricians and Gynecologists (ACOG) that routine episiotomy is unnecessary and may raise the risk of certain complications. This does not mean that episiotomy should never be performed, just not as a routine measure for all women undergoing vaginal delivery.
Despite the ACOG recommendation, it is estimated that up to 35 percent of vaginal deliveries involve routine episiotomy, lead author Dr. Katherine Hartmann, from the University of North Carolina at Chapel Hill, told Reuters Health. "I hope after our findings come out there will be a decline in use."
http://www.nlm.nih.gov/medlineplus/news/fullstory_24472.html