Obstetrics & Gynecology>>>>>Normal and Abnormal Labor and Delivery
Question 10#

A 29-year-old P0 at 41 weeks’ gestation presents in labor. At the time of delivery, a shoulder dystocia is encountered. An episiotomy is cut to assist with dystocia maneuvers.

Compared with a midline episiotomy, which of the following is an advantage of mediolateral episiotomy?

A. Ease of repair
B. Fewer breakdowns
C. Less blood loss
D. Lower incidence of dyspareunia
E. Less chance of extension of the incision

Correct Answer is E


Midline episiotomies are easier to repair, and have a lower incidence of surgical breakdown, involve less pain, and lower blood loss. However, the incidence of extensions of the incision to include the rectum is higher for midline episiotomies compared with mediolateral episiotomies. Mediolateral episiotomies lead to more pain, blood loss, and dyspareunia. Regardless of technique, attention to hemostasis and anatomic restoration is the key element of a technically appropriate repair.