Cochrane · systematic review · CD000081
Selective versus routine use of episiotomy for vaginal birth
Jiang, H, Qian, X, Carroli, G, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 28.6%Low 3 · 42.9%Moderate 2 · 28.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Selective versus routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated
Population: Women in labour where operative delivery was not anticipated. (Women were above 16 years old and between 28 gestational weeks and full term, with a live singleton fetus, without severe medical or psychiatric conditions, and had vaginal birth.)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Severe perineal/vaginal trauma Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | RR 0.7 [0.52, 0.94] | 8 studies · 5375 participants | Low Downgraded: imprecision, inconsistency, publication bias |
Blood loss at delivery Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | no estimate extracted | 2 studies · 336 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Babies with newborn Apgar score < 7 at 5 minutes Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | no estimate extracted | 2 studies · 501 participants | Moderate Downgraded: imprecision, inconsistency |
Perineal infection Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | RR 0.9 [0.45, 1.82] | 3 studies · 1467 participants | Low Downgraded: imprecision |
Women with moderate or severe pain (measured by visual analogue scale) Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | RR 0.71 [0.48, 1.05] | 1 study · 165 participants | Very low Downgraded: imprecision, indirectness |
Women with long‐term dyspareunia (≥ 6 months) Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | RR 1.14 [0.84, 1.53] | 3 studies · 1107 participants | Moderate Downgraded: imprecision |
Women with long‐term urinary incontinence (≥ 6 months) Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated | RR 0.98 [0.67, 1.44] | 3 studies · 1107 participants | Low Downgraded: risk of bias, imprecision |