Episiotomy and the risk of severe perineal injuries among Korean women

Abstract

Purpose: We examined the frequency of severe perineal injuries according to the use of episiotomy in vaginal deliveries of Korean women.Materials and methods: This is a retrospective cohort study in which 358 consecutive parturients were included. Women were divided into episiotomy (n=115) and no episiotomy (n=243) groups. The main outcome was the occurrence of severe (third or fourth degree) perineal injuries. Delivery records and medical documents were reviewed to collect the data. Parametric and nonparametric tests were used as appropriate.Results: There were no significant differences in the frequency of severe perineal injuries between two groups (6.1% (7/115) in episiotomy versus 3.7% (9/243) in no episiotomy group, p=0.308). Anterior perineal laceration was more frequent (40.3% (98/243) vs. 18.3% (21/115), p<0.001), but intact perineum was found in 15.6% (38/243) of women in no episiotomy group. Logistic regression analysis was performed to evaluate independent risk factors in the occurrence of severe perineal injuries including maternal age, parity, performance of episiotomy, head position at delivery, length of second stage of labor, birth weight, head circumference, and the use of vacuum during delivery. Only birthweight was a significant factor in predicting severe perineal injuries, and performance of episiotomy did not increase nor decrease the risk of severe perineal injury.Conclusions: There was no difference in the occurrence of severe perineal injuries according to the use of episiotomy.