Midline episiotomy and anal incontinence: retrospective cohort study
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Women who undergo episiotomy during childbirth have higher rates of anal incontinence during the first six months after giving birth compared to women who did not have episiotomies and even compared to those who experienced perineal tearing, report researchers in this week's BMJ.
Dr Lisa Signorello and colleagues from Harvard Medical School investigated 209 women who underwent a midline episiotomy whilst delivering a full term singleton baby vaginally; 206 who experienced spontaneous perineal tearing and 211 who experienced neither. They found that compared with women who tore naturally, episiotomy tripled the risk of faecal incontinence and doubled the risk of flatus incontinence in the six months after giving birth.
Signorello et al also determined that this effect of episiotomy was not due to its frequent association with instrumental delivery (for example forceps) and was independent of maternal age and complications during labour.
Based on their findings the authors conclude that episiotomy is not effective in protecting the perenium and sphincters during child birth and that the restricted use of episiotomy may prevent anal incontinence.
Contact:
Dr Lisa Signorello, Study Co-ordinator, International Epidemiology Institute, Rockville, USA
Tel:+1 301 517 4072
Email: lbsignore@aol.com
Or
Dr Bernard Harlow, Obstetrics and Gynaecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
Tel: +1 617 732 4897 or 617 732 4895