Use of Episiotomy in Obstetrical Care: A Systematic Review. Evident Report/Technology Assessment Number 112

摘要

In the United States, use of episiotomy varies from less than 10 percent to more than 75 percent of vaginal births. Overall, 30 to 35 percent of vaginal births include episiotomy. Routine episiotomy may not yield maternal benefits traditionally ascribed to it. We addressed five key questions (KQs): (1) Does the practice of liberal or routine episiotomy, compared to more selective use of episiotomy, influence maternal postpartum outcomes$ (2) Does episiotomy incision type (i.e., midline or mediolateral), influence maternal postpartum outcomes$ (3) Does the repair of the perineal defect (i.e., suture type and repair approach) influence maternal postpartum outcomes$ (4) Does episiotomy have a long-term influence on urinary incontinence, fecal incontinence, or pelvic floor defects$ and (5) Does episiotomy or incision type, or both, influence future sexual function.