Background: Obstetric anal sphincter injuries (OASIS) are reported to depend greatly on episiotomy angle. Episiotomy is done in almost all forceps deliveries.
Aim: To evaluate the extent of vaginal and perineal trauma using the angled episiotomy scissors versus straight scissors.
Design: Prospective comparative observational study conducted in 2 hospitals in Saudi Arabia.
Methods: 60 patients delivered by forceps were divided in 2 groups; angle episiotomy group (n=30) vs. straight episiotomy group (n=30), with each having given birth to in a different hospital. The primary outcome measures were the suture angle, suture distance from midline, length of episiotomy, and occurrence of OASIS. Secondary outcomes were pain and neonatal outcomes.
Results: Women with the angled episiotomy scissors, compared with those with straight scissors, had significantly higher post-delivery suture angle, and a longer post-delivery distance from midline. OASIS was significantly lower among angled episiotomy scissors group than among straight scissors group. There were no significant differences between both groups regarding pain or neonatal outcomes.
Conclusion: There has been a statistically significant reduction in OASIS in angled episiotomy scissors group during forceps assisted vaginal delivery and thus we recommend this.