Abstract
OBJECTIVE:
To compare the maternal and neonatal outcomes of operative vaginal delivery in relation to the use of episiotomy.
DESIGN:
Pilot randomised controlled trial (RCT).
SETTING:
Two urban maternity units in Scotland and England.
SAMPLE:
Nulliparous women anticipating a singleton cephalic vaginal delivery were recruited in the antenatal period.
METHODS:
If an operative vaginal delivery was required in the second stage of labour, women were randomised to either routine (in all cases) or restrictive (only if tearing apparent) use of episiotomy.
MAIN OUTCOME MEASURES:
The primary outcome was anal sphincter tearing (third or fourth degree). Secondary outcomes included postpartum haemorrhage (PPH), neonatal trauma and pelvic floor symptoms up until 10 days postpartum.