title: Modified median episiotomy minimizes the risk of third-degree tears.
abstract: The standard median episiotomy can be easily modified by adding two half-inch transverse cuts in opposite directions in the perineal fascia just above the anal sphincter. The use of this new technique, which is referred to as a modified median episiotomy, increases the diameter at the vaginal outlet 83% more than that provided by a median episiotomy alone. The increased diameter is also 10% greater than a mediolateral episiotomy alone. When an episiotomy is indicated, the exclusive use of this procedure makes the occurrence of third-degree tears extremely rare. The episiotomy is easy to repair.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas.
authors.forename: J L
authors.initials: JL
authors.lastname: May
mesh_terms: D004841:Episiotomy / Q000379:methods*; D005260:Female; D006801:Humans; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D012307:Risk Factors; D014947:Wounds and Injuries / Q000517:prevention & control