Evaluation of the incision angle of mediolateral episiotomy at 60 degrees |
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Authors: | Vladimir Kalis Jana Landsmanova Jaroslava Karbanova Zdenek Rokyta |
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Institution: | a Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republicb Department of Obstetrics, Oslo University Hospital, Oslo, Norway |
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Abstract: | ObjectiveTo study the angle of mediolateral episiotomy at the time of cut, after primary repair, and 6 months postpartum; and the incidence and severity of perineal pain and anal incontinence 6 months after delivery.MethodsThe study group comprised 60 consecutively recruited primiparous women who required episiotomy during delivery assisted by 2 obstetricians. The incision angle of episiotomy (defined as 60°) was measured before cutting, after primary repair, and after 6 months. At follow-up, perineal pain was evaluated by a verbal rating score; anal incontinence was assessed by St Mark's score.ResultsThe angles differed significantly among the incision (60°), repair (45°), and 6-month (48°) measurements (P < 0.001). There was a poor correlation between the suture angle and the angle measured at 6 months postpartum. No severe perineal tear was diagnosed in the cohort. At 6 months postpartum, only 1 woman reported mild symptoms of de novo anal incontinence, whereas 7 women reported perineal pain related to episiotomy.ConclusionAn incision angle of mediolateral episiotomy of 60° resulted in a low incidence of anal sphincter tearing, anal incontinence and perineal pain. A randomized controlled trial is needed to assess the outcome when different angles of episiotomy are used. |
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Keywords: | Definition Mediolateral episiotomy Perineum Surgery Vaginal birth |
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