The impact of selective episiotomy on maternal short-term morbidity: a retrospective study
Background The aim is to investigate the risk of short-term maternal morbidity caused by the selective clinical use of episiotomy (rate < 0.02), and to compare the risk of severe perineal tears with the statewide risk.Methods In this retrospective cohort study, we investigated the effect of selec...
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Obstetrics and Gynaecology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/01443615.2024.2369664 |
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| author | Gazal Radner Lukas Jennewein Dörthe Brüggmann Frank Louwen Ammar Al Naimi |
| author_facet | Gazal Radner Lukas Jennewein Dörthe Brüggmann Frank Louwen Ammar Al Naimi |
| author_sort | Gazal Radner |
| collection | DOAJ |
| description | Background The aim is to investigate the risk of short-term maternal morbidity caused by the selective clinical use of episiotomy (rate < 0.02), and to compare the risk of severe perineal tears with the statewide risk.Methods In this retrospective cohort study, we investigated the effect of selective episiotomy on the risk of severe perineal tears and blood loss in singleton term deliveries, using propensity scores with inverse probability weighting.Results This study included 10992 women who delivered vaginally between 2008–2018. Episiotomy was performed in 171 patients (1.55%), three of whom (1.75%) experienced severe perineal tears compared to 156 (1.44%) in the control cohort. The adjusted odds ratio of severe perineal tears was 2.06 (95% confidence interval [CI]: 0.51, 8.19 with 0.3 p value). Multivariate linear regression showed that episiotomy increased blood loss by 96.3 ml (95% CI: 6.4, 186.2 with 0.03 p value). Episiotomy was performed in 23% (95% CI: 0.228, 0.23) of vaginal deliveries in the state of Hessen, with a risk of severe perineal tears of 0.0143 (95% CI: 0.0139, 0.0147) compared to 0.0145 (95% CI: 0.0123, 0.0168) in our entire cohort.Conclusions Selective use of episiotomy does not increase the risk of higher-grade perineal tears. However, it may be associated with maternal morbidity in terms of increased blood loss. |
| format | Article |
| id | doaj-art-7f340e7d6156437a8551aa3e4bd5cd1f |
| institution | Kabale University |
| issn | 0144-3615 1364-6893 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | Journal of Obstetrics and Gynaecology |
| spelling | doaj-art-7f340e7d6156437a8551aa3e4bd5cd1f2025-01-09T12:13:17ZengTaylor & Francis GroupJournal of Obstetrics and Gynaecology0144-36151364-68932024-12-0144110.1080/01443615.2024.2369664The impact of selective episiotomy on maternal short-term morbidity: a retrospective studyGazal Radner0Lukas Jennewein1Dörthe Brüggmann2Frank Louwen3Ammar Al Naimi4Department of Obstetrics and Prenatal Medicine, Goethe-University Hospital, Frankfurt, GermanyDepartment of Obstetrics and Prenatal Medicine, Goethe-University Hospital, Frankfurt, GermanyDepartment of Obstetrics and Prenatal Medicine, Goethe-University Hospital, Frankfurt, GermanyDepartment of Obstetrics and Prenatal Medicine, Goethe-University Hospital, Frankfurt, GermanyDepartment of Obstetrics and Prenatal Medicine, Goethe-University Hospital, Frankfurt, GermanyBackground The aim is to investigate the risk of short-term maternal morbidity caused by the selective clinical use of episiotomy (rate < 0.02), and to compare the risk of severe perineal tears with the statewide risk.Methods In this retrospective cohort study, we investigated the effect of selective episiotomy on the risk of severe perineal tears and blood loss in singleton term deliveries, using propensity scores with inverse probability weighting.Results This study included 10992 women who delivered vaginally between 2008–2018. Episiotomy was performed in 171 patients (1.55%), three of whom (1.75%) experienced severe perineal tears compared to 156 (1.44%) in the control cohort. The adjusted odds ratio of severe perineal tears was 2.06 (95% confidence interval [CI]: 0.51, 8.19 with 0.3 p value). Multivariate linear regression showed that episiotomy increased blood loss by 96.3 ml (95% CI: 6.4, 186.2 with 0.03 p value). Episiotomy was performed in 23% (95% CI: 0.228, 0.23) of vaginal deliveries in the state of Hessen, with a risk of severe perineal tears of 0.0143 (95% CI: 0.0139, 0.0147) compared to 0.0145 (95% CI: 0.0123, 0.0168) in our entire cohort.Conclusions Selective use of episiotomy does not increase the risk of higher-grade perineal tears. However, it may be associated with maternal morbidity in terms of increased blood loss.https://www.tandfonline.com/doi/10.1080/01443615.2024.2369664Episiotomyperineal tearsinstrumental delivery |
| spellingShingle | Gazal Radner Lukas Jennewein Dörthe Brüggmann Frank Louwen Ammar Al Naimi The impact of selective episiotomy on maternal short-term morbidity: a retrospective study Journal of Obstetrics and Gynaecology Episiotomy perineal tears instrumental delivery |
| title | The impact of selective episiotomy on maternal short-term morbidity: a retrospective study |
| title_full | The impact of selective episiotomy on maternal short-term morbidity: a retrospective study |
| title_fullStr | The impact of selective episiotomy on maternal short-term morbidity: a retrospective study |
| title_full_unstemmed | The impact of selective episiotomy on maternal short-term morbidity: a retrospective study |
| title_short | The impact of selective episiotomy on maternal short-term morbidity: a retrospective study |
| title_sort | impact of selective episiotomy on maternal short term morbidity a retrospective study |
| topic | Episiotomy perineal tears instrumental delivery |
| url | https://www.tandfonline.com/doi/10.1080/01443615.2024.2369664 |
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