Episiotomy And Operative Vaginal Delivery: Do We Need More Evidence?

Operative vaginal delivery (OVD) is recognised as a major risk factor in the occurrence of obstetric anal sphincter injuries (OASIs), particularly during first vaginal deliveries. All large observational studies based on prospectively collected databases have shown the benefits of mediolateral episiotomy performed during OVD in nulliparous women (Sultan et al. Eur J Obstet Gynecol Reprod Biol. 2019;240:192-196).