Controversial benefit of episiotomy on maternal and fetal outcomes A prospective comparative clinical study

Background: Episiotomy is performed as one of the most common surgeries procedure to facilitate delivery and prevent complications of hard labor in both mother and her neonate. Routine episiotomy is a controversial issue among gynecologists. Objectives: To evaluate the controversial benefit of episiotomy by comparing planned episiotomy vs. planned non-episiotomy as regard to maternal and fetal outcomes during spontaneous vaginal delivery. Patients and methods: 400 pregnant women (primi & second gravidae), full term gestation were recruited from those attending delivery ward of Obstetrics and Gynecology department of Al-Azhar university hospital in Assiut during the period started from January 2018 till August 2018 . Women were classified into 2 groups according to planned episiotomy (Group I =200 woman) or no episiotomy (Group II= 200 woman). Each group was assessed during the early postnatal period for fetal and maternal outcomes and throughout the duration of puerperium for evaluation of maternal morbidities. Results: In term pregnancies with spontaneous vaginal deliveries, the episiotomy group had more risk of physical and psychological morbidities than non-episiotomy group, however fetal outcomes were the same in both groups. Conclusion: Episiotomy is not essential or beneficial in every delivery, so it should not be a routine procedure during delivery and should be individualized according to obstetrician experience and maternal and/or fetal indications.