Episiotomy and the perineum: a random controlled trial

SummaryA random controlled trial comparing restricted and liberal use of episiotomy was conducted. In the patients in whom the use of episiotomy was restricted (episioto-mies 32 per cent in primigravidae, 2 per cent in multi-gravidae), 32 per cent of primigravidae and 54 per cent of multigravidae had an intact perineum or a first degree tear. With liberal use of episiotomy (primigravidae 79 per cent, multigravidae 48 per cent), only 4 per cent of primigravidae and 26 per cent of multigravidae had an intact perineum or a first degree tear. Symptoms on the 3rd day postpartum were, on average, reduced in the patients in whom the use of episiotomy was restricted.