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Selected Use of Midline Episiotomy: Effect on Perineal Trauma


Thorp, John M., Jr.; Bowes, Watson A., Jr.; Brame, Robert G.; & Cefalo, Robert C. (1987). Selected Use of Midline Episiotomy: Effect on Perineal Trauma. Obstetrics & Gynecology, 70(2), 260-262.


A prospective, nonrandomized controlled study was performed to determine the effect of using midline episiotomy only for mothers who experienced fetal distress and/or operative vaginal delivery. Such a policy resulted in a significant decline in third- and fourth-degree lacerations in nulliparous women. This reduction was most pronounced in nulliparous women delivering infants larger than 3400 g. No third- or fourth-degree laceration occurred without antecedent episiotomy in any woman. A policy of using episiotomy selectively appears to lower the incidence of perineal trauma.


Reference Type

Journal Article

Year Published


Journal Title

Obstetrics & Gynecology


Thorp, John M., Jr.
Bowes, Watson A., Jr.
Brame, Robert G.
Cefalo, Robert C.