The incision angle of mediolateral episiotomy before delivery and after repair.
OBJECTIVE
To assess the relevance of the suture angle when evaluating mediolateral episiotomy, and the safety of the accepted lower limit of 40 degrees for the incision angle.


METHODS
The angles formed by the incision and suture lines with the midline were measured, and any perineal tear noted, in 50 consecutive women undergoing their first vaginal delivery.


RESULTS
The angles were significantly different (40 degrees and 22.5 degrees , respectively; P<0.001). The only variable significantly linked to the difference was the timing of the episiotomy.


CONCLUSIONS
The suture angle cannot currently be used to assess the adequacy of the incision angle; moreover, an incision angle of 40 degrees is probably too acute to prevent potential sphincter damage.
Kalis
Vladimir
V
Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic. kalisv@fnplzen.cz
Karbanova
Jaroslava
J
Horak
Miroslav
M
Lobovsky
Libor
L
Kralickova
Milena
M
Rokyta
Zdenek
Z
D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D015331:Cohort Studies; D004841:Episiotomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D010502:Perineum / Q000293:injuries / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D013536:Suture Techniques; D013997:Time Factors