A new study from Johns Hopkins suggests that routine widening of the vagina, a procedure known as an episiotomy, does not reduce the risk of injury to infants during a complicated birth, such as when a babys shoulders are stuck in the birth canal after the head is already out. Instead, physicians can proceed directly to physical maneuvering of the infant, thereby avoiding unnecessary trauma to the mother and, at the same time, averting injury to the baby. An episiotomy should only be performed when more room is required to carry out maneuvers to dislodge an infant.
"Most textbooks in obstetrics still recommend that physicians perform a generous episiotomy, yet there is no evidence that the procedure will reduce the likelihood of injury to the infant," said high-risk obstetrician Edith Gurewitsch, M.D., an assistant professor at The Johns Hopkins University School of Medicine and lead author of the study, presented at the 24th annual meeting of the Society for Maternal-Fetal Medicine and set for publication in the American Journal of Obstetrics and Gynecology online Oct. 5.
"Episiotomy will only eliminate soft tissue barriers to delivery, whereas rotating the infant will realign its shoulders to fit within the mothers pelvis. It is the bony pelvis that is widely acknowledged as the main cause for the infant getting caught in the birth canal."
David March | EurekAlert!
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