Prognosis Effects of Restrictive Episiotomy Versus Routine Episiotomy on Puerpera and Newborn : a Meta Analysis

LIU Lian; PAN Xin-yu; YANG Xiao-ling; HUANG Yan-fang; SUN hong-yan

doi:10.3969/j.issn.1002-3429.2017.05.027

Abstract：Objective To evaluate effects of restrictive episiotomy (REE) and routine episiotomy (ROE) on prognosis of puerpera and newborn.Methods All randomized controlled trials (RCTs) papers concerning REE and ROE on prognosis of puerpera and newborn were retrieved and chosen from PubMed, Embase, Cochrane Library, CNKI, Wanfang database and VIP full-text database (VIP) during establishment and Augest 2016.Meta-analysis was conducted by using the statistical software RevMan 5.3.1.Results A total of 15 papers (6377 patients) were included in the study.Meta analysis showed that grade Ⅰ and Ⅱ perineal laceration rate in REE group was higher than that in ROE group [RR=6.24, 95%CI (1.85, 21.04), P=0.003].In REE group, duration of the second stage of labor was slightly longer than that in ROE group [MD=1.45, 95%CI (0.28, 2.61), P=0.01];perinaeum incision rate was decreased [RR=0.35, 95%CI (0.28,0.43), P<0.00001];perinaeum integrity rate was significantly increased [RR =2.43, 95%CI (1.12, 5.24, P=0.02];intrapartum bleeding volume was significantly reduced [MD=-32.02,95%CI (-61.42,-2.62), P=0.03];incidence rate of serious postpartum perineal pain was significantly decreased [RR=0.37, 95%CI(0.27,0.51), P<0.00001];incidence rates of the maternal postpartum sexual dysfunction was decreased [RR=0.38, 95%CI (0.24,0.58), P<0.0001];incidence rate of other postpartum complications [RR=0.54, 95%CI (0.36,0.80), P=0.002] and value of hospital stay [MD=-0.89, 95% CI (-1.44,-0.35), P=0.001] were superior to those in ROE group.Conclusion The study shows that restrictive episiotomy can relieve wound, promote postoperative recovery and improve postoperative quality of life without effects on newborn compared with those by ROE.However, available papers are not adequate to draw a conclusion due to the methodological flaws of the included trials, while high quality, large sample and multicenter randomized controlled trials are needed to confirm the findings.