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Pelvic Floor Outcomes In Relation To The Incision Angle Of Mediolateral Episiotomy

Conference

Objective: To assess the pelvic floor outcomes in relation to the incision angle of mediolateral episiotomy in primigravid women.

 

Methods: This was a prospective observational study of 51 primigravid women who had mediolateral episiotomies performed during vertex delivery at UKMMC between February to April 2018. Demographic and obstetric data were collected. The resultant episiotomy angle, length and depth, and length of perineal body were measured. The incidence of obstetric anal sphincter injuries (OASIS), episiotomy wound breakdown and perineal pain (by visual analogue scale) 2 weeks postpartum were documented. Analysis of the episiotomy characteristics in association with OASIS, wound breakdown and perineal pain was done.  

 

Results: The median resultant episiotomy angle was 20 º (20-30). Two cases (3.9%) of obstetric anal sphincter injuries (OASIS) and wound breakdown were observed, respectively. The episiotomy angle was not significantly associated with perineal pain in this study (p ≥ 0.13).

Conclusion: A smaller episiotomy incision angle was observed in cases of OASIS whereas a wider episiotomy incision angle was observed in cases of episiotomy wound breakdown. The episiotomy angle was not significantly associated with perineal pain in this study. Larger-scale research is needed to establish the relationship between pelvic floor outcomes and the episiotomy incision angle.

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