Study on the Restrictive Use of Episiotomy in Spontaneously Vaginal Delivery and the Type of Episiotomy

Objective: To explore the restrictive use of episiotomy in spontaneously vaginal delivery;and to compare the effects of midline and mediolateral episiotomies on delivery.Methods:A retrospective study was conducted including 586 vaginal delivery women at ≥37 weeks of gestation with live singleton cephalic pregnancies,who were recruited from March 2012 to June 2012 in the first affiliated hospital of Chongqing Medical University,among whom 196 women were with no episiotomy,270 women were with mediolateral episiotomy,120 women were with midline episiotomy.The maternal and neonatal outcomes of three types of episiotomy were compared.Results:The postpartum hemorrhage,length of stay after childbirth,time to resuming sexual intercourse,postpartum sexual satisfaction and maximum perineal pain severity of no episiotomy were significantly decreased than midline and mediolateral episiotomy groups (P005);at the same time there were no statistical significant differences between midline and mediolateral episiotomy groups (P005).No statistical significant differences in postnatal infection,preventive use of antibiotics,postnatal urinary incontinence,pelvic organ prolapse,neonatal apgar score and umbilical arterial pH value was found among three groups (P005).ⅠtoⅡ perineal tears of midline episiotomy group(667%)were significantly higher than mediolateral episiotomy group(148%)(P005).Conclusions:In the course of delivery,avoiding routine episiotomy in unnecessary conditions would increase the rate of intact perineal with no adverse effects on maternal and neonatal morbidities.To reduce perineal trauma,a mediolateral rather than midline approach when episiotomy is indicated is prioritizing.