title: The incision angle of mediolateral episiotomy before delivery and after repair.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic. kalisv@fnplzen.cz
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kalis
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Karbanova
authors.forename: Miroslav
authors.initials: M
authors.lastname: Horak
authors.forename: Libor
authors.initials: L
authors.lastname: Lobovsky
authors.forename: Milena
authors.initials: M
authors.lastname: Kralickova
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rokyta
mesh_terms: 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