Manual Delivery Without Need for Episiotomy

They compared outcomes for both baby and mother when doctors used either episiotomies without manual techniques or manual techniques without episiotomy to finish delivering the baby. Of 40 cases, 24 babies had permanent brachial plexus damage, 12 had poor Apgar scores at birth, and 20 of the mothers had severe perineal injuries involving the anal sphincter muscle. Of the 38 cases where manual techniques were used, 15 babies had permanent brachial plexus damage and six had poor Apgar scores, but only one mother had a severe perineal injury.

"If manual techniques alone can be used to deliver the baby, the mother can be spared a significant perineal injury, and there might even be fewer complications for the infant after delivery,” said lead author Edith Gurewitsch, M.D., assistant professor of gynecology/obstetrics at Johns Hopkins.




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