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01.12.2017 | Original Article

The optimal angle of the mediolateral episiotomy at crowning of the head during labor

verfasst von: Shimon Ginath, Osnat Elyashiv, Eran Weiner, Ron Sagiv, Jacob Bar, Joseph Menczer, Michal Kovo, Alexander Condrea

Erschienen in: International Urogynecology Journal | Ausgabe 12/2017

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Abstract

Introduction and hypothesis

The aim of the mediolateral episiotomy incision is to increase the diameter of the soft tissue of the vaginal outlet to facilitate birth and to prevent vaginal tears. Episiotomy angles that are too narrow and close to the midline increase the risk of obstetric anal sphincter injuries. In order to determine the optimal angle of the episiotomy, we assessed the changes in the angles of episiotomy lines marked during the first stage of labor and measured at the time of crowning of the head.

Methods

Incision lines for mediolateral episiotomy were marked on the perineal skin at angles of 30°, 45°, and 60° from the midline during the first stage of labor in women with a singleton pregnancy. The angles of the marked lines were measured at crowning of the head. Mediolateral episiotomy was performed only for obstetric indications.

Results

The study included 102 women with a singleton pregnancy. Of these women, 50 were primiparous and 52 were multiparous. All angles marked during the first stage of labor increased significantly (by more than 30°) at crowning of the head. Similar changes were observed in primiparous and multiparous women.

Conclusions

The angle of the mediolateral episiotomy line was significantly greater at crowning of the head than when marked during the first stage of labor. To achieve the desired episiotomy angle, it is important to take into consideration the changes in mediolateral episiotomy angles that occur during labor.

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Titel: The optimal angle of the mediolateral episiotomy at crowning of the head during labor
verfasst von: Shimon Ginath
Osnat Elyashiv
Eran Weiner
Ron Sagiv
Jacob Bar
Joseph Menczer
Michal Kovo
Alexander Condrea
Publikationsdatum: 01.12.2017
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 12/2017
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3349-9

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The optimal angle of the mediolateral episiotomy at crowning of the head during labor