Atef, A., Fahmy, T., Abu-Elfotouh, I., Kotb, M. (2022). The Safety of Selective Episiotomy Compared to Routine Episiotomy During Vaginal Birth in Primigravida in Cairo University Hospitals. The Egyptian Journal of Hospital Medicine, 89(1), 5023-5027. doi: 10.21608/ejhm.2022.261166
Adel Atef; Taher Abd-Elazeem Fahmy; Ismail Ibrahim Abu-Elfotouh; Mohamed Mahmoud Mohamed Kotb. "The Safety of Selective Episiotomy Compared to Routine Episiotomy During Vaginal Birth in Primigravida in Cairo University Hospitals". The Egyptian Journal of Hospital Medicine, 89, 1, 2022, 5023-5027. doi: 10.21608/ejhm.2022.261166
Atef, A., Fahmy, T., Abu-Elfotouh, I., Kotb, M. (2022). 'The Safety of Selective Episiotomy Compared to Routine Episiotomy During Vaginal Birth in Primigravida in Cairo University Hospitals', The Egyptian Journal of Hospital Medicine, 89(1), pp. 5023-5027. doi: 10.21608/ejhm.2022.261166
Atef, A., Fahmy, T., Abu-Elfotouh, I., Kotb, M. The Safety of Selective Episiotomy Compared to Routine Episiotomy During Vaginal Birth in Primigravida in Cairo University Hospitals. The Egyptian Journal of Hospital Medicine, 2022; 89(1): 5023-5027. doi: 10.21608/ejhm.2022.261166
The Safety of Selective Episiotomy Compared to Routine Episiotomy During Vaginal Birth in Primigravida in Cairo University Hospitals
Lecturer of obstetrics and gynecology, Cairo university, Egypt
Abstract
Background: Episiotomy is a surgical procedure that can result in postpartum hemorrhage, perineal pain, and dyspareunia. Moreover, episiotomy is not totally protective against severe perineal lacerations or maternal and neonatal morbidity; thus, its benefit in reducing the occurrence of severe perineal tears has to be investigated. Objectives: We aimed to assess the pros and cons of a policy of selective episiotomy (only if needed) compared with a policy of routine episiotomy (part of routine management) for vaginal births. Methodology: Nulliparous women in the active phase of labor with gestational age 37-41 and a single viable fetus with vertex presentation attending the Obstetrics and Gynecology Emergency Department, Kasr Al Aini Cairo University Hospital were included. One hundred and twenty laboring women were divided into 2 groups. Group A: Conducting routine episiotomy and Group B: Conducting selective episiotomy. Results: There was no significant difference between the groups regarding the incidence of perineal tears and obstetrical anal sphincter injuries (OASIS). Conclusion: In comparison to conventional episiotomy, selective episiotomy is equally risky for severe perineal/vaginal trauma. In Egypt, obstetric and tertiary care establishments may recommend selective episiotomy. Regarding the volume of intrapartum blood loss, selective episiotomy is superior to routine episiotomy.
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