Management of the perineum during forceps delivery. Association of episiotomy with the frequency and severity of perineal trauma in women undergoing forceps delivery.
OBJECTIVE
To examine the association of the frequency and severity of perineal trauma with episiotomy performed at forceps delivery.


METHODS
This retrospective study analyzed all forceps deliveries at the Semmelweis Women's Hospital Vienna between February 1999 and July 1999. Evaluation of a possible association of episiotomy with the frequency and severity of perineal trauma was the main objective of the study. Episiotomy was not performed routinely and was either midline or mediolateral.


RESULTS
In conjunction with forceps delivery episiotomy, 76/87 women (87%) underwent forceps delivery episiotomy; among those, 49/76 (64%) had a mediolateral episiotomy and 27/76 (36%) a midline episiotomy. The frequency and severity of perineal tears were significantly lower in forceps deliveries when an episiotomy was performed. When analyzing the type of episiotomy, the data revealed a statistically significantly lower frequency of perineal trauma when mediolateral episiotomy was performed as compared to midline episiotomy.


CONCLUSIONS
If obstetric indications necessitate forceps delivery, performance of an episiotomy decreases the risk of perineal tears of all degrees. When analyzing the type of episiotomy, mediolateral episiotomy seems to be more protective against perineal trauma in women undergoing forceps delivery.
Department of Obstetrics and Gynecology and of Anesthesiology, University of Vienna Medical School, Department of Obstetrics and Gynecology, Semmelweis Women's Hospital Vienna, Vienna, Austria. barbara.bodner-adler@akh-wien.ac.at
Barbara
B
Bodner-Adler
Klaus
K
Bodner
Oliver
O
Kimberger
Peter
P
Wagenbichler
Klaus
K
Mayerhofer
D000328:Adult; D004841:Episiotomy / Q000379:methods*; D005113:Extraction, Obstetrical / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015601:Injury Severity Score; D007744:Obstetric Labor Complications / Q000517:prevention & control; D009772:Obstetrical Forceps; D010298:Parity; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*