title: Effect of timing of episiotomy repair on peripartum blood loss.
abstract: BACKGROUND
  To evaluate the effect of timing of episiotomy repair on peripartum blood loss.
  
  
  METHODS
  In this case-controlled study, nulliparous women were grouped as: group 1: no episiotomy (control; n = 82); group 2: midline episiotomy repair after placental removal (n = 76); group 3: midline episiotomy repair before placental removal (n = 78); group 4: mediolateral episiotomy repair after placental removal (n = 84), and group 5: mediolateral episiotomy repair before placental removal (n = 80). Hemoglobin and hematocrit values were evaluated at admission and 24 h postpartum.
  
  
  RESULTS
  The reductions in hemoglobin and hematocrit in all episiotomy groups (groups 2-5) were significantly more than that of control (group 1) (p < 0.05). There was no difference among midline episiotomy groups (groups 2 and 3) whereas a significant difference existed among mediolateral groups (groups 4 and 5) (p < 0.05). When episiotomy repair was done after placental removal, there was a significant difference between midline and mediolateral techniques (groups 2 and 4) (p < 0.05). When repair was done before placental removal, there was no difference in the amount of blood loss regardless of technique (between groups 3 and 5).
  
  
  CONCLUSIONS
  Episiotomy should be avoided to decrease the amount of peripartum blood loss. However, if mediolateral episiotomy is to be performed, it should be repaired before placental removal to decrease the amount of peripartum blood loss.
authors.affiliation: Gynecology and Obstetrics Clinic, Sişli Etfal Training and Research Hospital, Istanbul, Turkey. basakbaksu@yahoo.com
authors.forename: Basak
authors.initials: B
authors.lastname: Baksu
authors.forename: Inci
authors.initials: I
authors.lastname: Davas
authors.forename: Atif
authors.initials: A
authors.lastname: Akyol
authors.forename: Jale
authors.initials: J
authors.lastname: Ozgul
authors.forename: Figen
authors.initials: F
authors.lastname: Ezen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004841:Episiotomy; D005260:Female; D006801:Humans; D019106:Postoperative Hemorrhage / Q000601:surgery*; D013997:Time Factors