Episiotomy: A Preventive Medication of Extensive Genital Tract Trauma or a Risk Factor

At the present time, more than 80% of the first and second deliveries are made using episiotomy, while researchers attribute many side-effects to this method. On the other hand, there are controversies over the advantages of this method, specially it's most important advantage in the prevention of severe genital tract trauma. This research was carried out to compare the frequency of the incidence of genital tract trauma between two groups undergoing episiotomy, namely routine and selective episiotomy groups. This research was carried out' using the clinical trial method on 730 patients having their deliveries at Imam-Khomeni and Faterna-Zahra (AS) Hospitals of Sari.Individual cases were divided randomly in two groups of routine and selective episiotomy. All the deliveries were carried out by the obstertrics and gynechology residents. Then, a questionnaire designed to collect thepatients information was filled for every patient by a midwife who didnt know which group the patient was belonged to. Then, the two groups were compared with rgards to the frequency of genital tract trauma. Results showed a 71.1% and 84.5% frequency of episiotomy in the selective and routine groups respectively. Statistical tests showed no significant difference between the frequency of genital tract trauma in the selective and routine groups.Comparison of the cases having episiotomy indicated that all the extensive genital tract trauma (grade 3 and 4) were in the routine group. The hypothesis of this research stating that: "The performance of episiotomy plays a role in the severe genital tract trauma" was proved. Hence, it is proposed that the authorities pay more attention to the performance of episiotomy being solely based on the indications followed by the proper control of perineum to reduce the frequency of episiotomy.