Study On The Resrictive Use Of Episiotomy In Spontaneously Vaginal Delivery And The Type Of Episiotomy

Objective:To explore the restrictive use of episiotomy inspontaneously vaginal delivery in China; And compare the effects ofmidline and mediolateral episiotomies on delivery.Methods: A retrospective study was conducted including586vaginaldelivery women at≥37weeks of gestation with live singleton cephalicpregnancies，who were recruited from March2012to june2012in the firstaffiliated hospital of Chongqing Medical University.196women with noepisiotomy,270women with mediolateral episiotomy,120women withmidline episiotomy. The maternal and neonatal outcomes of three types ofepisiotomy were compared.Results：No statistical significant difference in general information ofpregnant women and neonate among three groups；Significant differencewas found with regard to postpartum hemorrhage and postpartum sexualdysfunction and maximum perineal pain severity and length of stay afterchildbirth and time to resuming sexual intercourse between the noepisiotomy and episiotomy groups (P＜0.05)，and the outcomes were significantly decreased in the no episiotomy group；but no statisticalsignificant difference in postnatal urinary incontinence and pelvic organprolapse and postnatal infection and neonatal asphyxia rate among threegroups(P＞0.05).No statistical significant difference was found with regardto postpartum hemorrhage and postpartum sexual dysfunction andmaximum perineal pain severity and postnatal infection and postnatalurinary incontinence and pelvic organ prolapse and length of stay afterchildbirth and time to resuming sexual intercourse and neonatal asphyxiarate between midline and mediolateral episiotomy groups (P＞0.05)，whereas perineal tears were significantly higher in the midline episiotomygroup(P＜0.05).Conclusions: In the course of delivery, no episiotomy would decreasepostpartum hemorrhage and postpartum sexual dysfunction and maximumperineal pain severity， and shorten the length of stay after childbirth，andpromote resuming sexual intercourse，meanwhile there were no adverseeffects on maternal and neonatal morbidities. We stress the importance ofadvocating restrictive use of episiotomy．To reduce perineal trauma,Whenepisiotomy is indicated, we suggest a mediolateral rather than medianapproach.