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Title: CUTTING MEDIO-LATERAL EPISIOTOMY AT CORRECT ANGLE TO PREVENT OASI
e-poster Number: EP 400
Category: Maternal and Fetal Health?
Author Name: Dr. Ritu Mann
Institute: AIIMS DELHI
Co-Author Name:
Abstract :
Introduction: Episiotomy is a common surgical procedure during childbirth, designed to prevent severe perineal lacerations. It's association with long-term complications, particularly Obstetric Anal Sphincter Injuries (OASI), remains a significant concern.
Aims and Objectives: To determine the post-delivery incision angles, incidence of Obstetric Anal Sphincter Injuries (OASI), and average blood loss in patients undergoing modified 60? medio-lateral episiotomy vs those undergoing conventional episiotomy.
Material and Methods: A randomized controlled trial was conducted in which a total of 120 participants were randomized into a study group (n=60) (modified 60? episiotomy) and a control group (n=60) (conventional eye-balling 45? episiotomy). For the modified episiotomy technique, scissors with a marker limb that points towards the anus was used, and using a protractor, 60? angles were marked between the scissor and the limb, which was used to make the episiotomy incision after ensuring safety through simulator models.
Results: There was no statistically significant association between demographic factors (age, socioeconomic status, and parity) and OASI incidence. In multigravida, a 60? cutting angle significantly reduced high-grade perineal injury incidence (p=0.04). Post-delivery episiotomy angles were significantly higher in the study group (44.9?) than control group (30.9?) with lower OASI incidences (3.3% in study vs 15% in control group). Instrumental delivery significantly increased OASI incidence, while factors like prolonged labor or history of previous surgery did not show strong associations.
Conclusions: The study concludes that the modified 60? medio-lateral episiotomy reduces the risk of severe perineal injuries and OASI, suggesting it may be a more effective technique for minimizing complications in childbirth. Difference in post-delivery angles between the two groups aligns with the hypothesis that higher angles reduce OASI risk. Further research is needed to confirm these findings and explore long-term outcomes.
