title: The role of episiotomy in current obstetric practice.
abstract: This review traces the clinical use of episiotomy from the eighteenth century to the present and explains why the procedure has a restricted function in current practice. The types of episiotomy are described, and the controversies surrounding the sequelae associated with the procedure are explored. The modern indications for episiotomy including the procedure's place at operative vaginal delivery are discussed. Although the role of the episiotomy in modern obstetrics may be limited, the procedure is important in situations involving nonreassuring fetal status, shoulder dystocia, and perhaps operative vaginal delivery. The optimal type of episiotomy, if any, at forceps or vacuum delivery is yet to be determined.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Cleary-Goldman
authors.forename: Julian N
authors.initials: JN
authors.lastname: Robinson
mesh_terms: D004841:Episiotomy / Q000009:adverse effects / Q000266:history / Q000379:methods / Q000639:trends; D005260:Female; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D009774:Obstetrics / Q000379:methods / Q000639:trends; D011247:Pregnancy