Site and incidence of birth canal lacerations from instrumental delivery with mediolateral episiotomy

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• 作者：Kenro Chikazawa ; Junko Ushijima ; Kenjiro Takagi ; ^{kenjirotakagi@me.com} ; Eishin Nakamura ; Koki Samejima ; Kanako Kadowaki ; Isao Horiuchi
• 关键词：episiotomy ; forceps delivery ; operative vaginal delivery ; perineal laceration ; vacuum delivery
• 刊名：Taiwanese Journal of Obstetrics and Gynecology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：55
• 期：6
• 页码：861-862
• 全文大小：248 K
• 卷排序：55

文摘

Instrument-assisted vaginal delivery is a significant risk factor for birth canal lacerations. Although many obstetricians recently are recommending restrictive rather than a routine episiotomy, reports have shown restrictive episiotomy to be associated with more extensive anterior birth canal trauma compared with routine episiotomy.Materials and MethodsWe retrospectively reviewed 110 cases of forceps and vacuum deliveries and investigated the site of birth canal lacerations. Birth canal lacerations were divided into four sites according to direction—anterior, ipsilateral, contralateral, and posterior.ResultsThe frequency of lacerations were, from most to least, posterior (34%), lateral (21.7%), and anterior (1.9%). Moreover, among the lateral lacerations, they were more frequent in the contralateral side of episiotomy than the ipsilateral side (18.9% vs. 4.7%, p < 0.01).ConclusionOur results indicate that caution is also needed concerning not only the anterior site, but also the contralateral site of an episiotomy to prevent laceration in an instrument-assisted vaginal delivery.