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Evaluation of the incision angle of mediolateral episiotomy at 60 degrees
Author(s) -
Kalis Vladimir,
Landsmanova Jana,
Bednarova Barbora,
Karbanova Jaroslava,
Laine Katariina,
Rokyta Zdenek
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2010.09.015
Subject(s) - medicine , episiotomy , surgery , orthodontics , pregnancy , biology , genetics
Objective To study the angle of mediolateral episiotomy at the time of cut, after primary repair, and 6 months postpartum; and the incidence and severity of perineal pain and anal incontinence 6 months after delivery. Methods The study group comprised 60 consecutively recruited primiparous women who required episiotomy during delivery assisted by 2 obstetricians. The incision angle of episiotomy (defined as 60°) was measured before cutting, after primary repair, and after 6 months. At follow‐up, perineal pain was evaluated by a verbal rating score; anal incontinence was assessed by St Mark's score. Results The angles differed significantly among the incision (60°), repair (45°), and 6‐month (48°) measurements ( P < 0.001). There was a poor correlation between the suture angle and the angle measured at 6 months postpartum. No severe perineal tear was diagnosed in the cohort. At 6 months postpartum, only 1 woman reported mild symptoms of de novo anal incontinence, whereas 7 women reported perineal pain related to episiotomy. Conclusion An incision angle of mediolateral episiotomy of 60° resulted in a low incidence of anal sphincter tearing, anal incontinence and perineal pain. A randomized controlled trial is needed to assess the outcome when different angles of episiotomy are used.