title: Advantage or disadvantage of episiotomy compared with spontaneous perineal laceration.
abstract: In a prospective clinical investigation of 2,144 deliveries, we elucidate the indications for episiotomy and how different methods of anesthesia affect the frequency of episiotomy and the perineal problems after episiotomy compared with those after spontaneous perineal laceration. We found a significantly higher infection rate (p less than 0.001) and a longer healing period in the episiotomy group. These differences remain even if only primigravida or the indication, imminent perineal laceration, is studied. The results indicate that many women will unnecessarily suffer after an episiotomy. The patient's subjective problems are significantly increased, both immediately and at the 3-month postoperative follow-up.
authors.affiliation: Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
authors.forename: P G
authors.initials: PG
authors.lastname: Larsson
authors.forename: J J
authors.initials: JJ
authors.lastname: Platz-Christensen
authors.forename: B
authors.initials: B
authors.lastname: Bergman
authors.forename: G
authors.initials: G
authors.lastname: Wallstersson
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000773:Anesthesia, Obstetrical / Q000379:methods / Q000592:standards; D004841:Episiotomy / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007744:Obstetric Labor Complications; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D010298:Parity; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D013536:Suture Techniques / Q000592:standards; D014945:Wound Healing; D014950:Wounds, Penetrating / Q000150:complications*
chemical_list: D000700:Analgesics