Drop in episiotomy not tied to increase in obstetric anal sphincter injury for most women

Medical Xpress / HealthDay / PLOS Medicine ^ | Jan. 17, 2025 | Lori Solomon / Raphaele Houlbracq et al

[ConservativeMind]

A significant overall reduction in the prevalence of episiotomy in France from 2010 to 2021 has not been followed by an overall increase in obstetric anal sphincter injury (OASI), according to a study.

Raphaele Houlbracq and colleagues assessed variations in the prevalence of both episiotomy and OASI using data from the 2010, 2016, and 2021 National Perinatal Surveys (29,750 women with a vaginal delivery).

The researchers found that the overall prevalence of episiotomy decreased significantly from 25.8% in 2010, to 20.1% in 2016, and to 8.3% in 2021 (adjusted risk ratio, 0.33). This trend persisted across all groups of the classification, ranging from −33.0% in nulliparous women with a term cephalic singleton undergoing forceps delivery to −94.0% in those with multiple pregnancy.

In an adjusted analysis, the difference in overall prevalence of OASI between 2010 (0.7%) and 2021 (1.0%) was not statistically significant. Among the classification groups, only nulliparous women with a term cephalic singleton undergoing spatula delivery experienced a significant increase in the prevalence OASI.

"Our results and recent literature suggest that there is a need to reconsider indications of restrictive episiotomy policies for instrumental deliveries in nulliparous women," the authors write.

[DPMD]

Paul the Apostle or Paul the MD?

[crusty old prospector]

That dude in The Beatles.