The use of Episcissors-60 to reduce the rate of Obstetric Anal Sphincter Injuries: A systematic review

Eur J Obstet Gynecol Reprod Biol. 2019 Jun;237:23-27. doi: 10.1016/j.ejogrb.2019.04.004. Epub 2019 Apr 6.


Objectives: The aim of this systematic review is to evaluate the effect of Episcissors-60, which were designed to improve the accuracy of episiotomies, on the rate of Obstetric Anal Sphincter Injuries.

Study design: This review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42018094935). A literature search of the PubMed, Embase and Cochrane databases was performed from inception to May 2018. All peer-reviewed studies evaluating the use of Episcissors-60 in clinical practice and the resulting Obstetric Anal Sphincter Injury incidence were included. Data on study population demographics, incidence of Obstetric Anal Sphincter Injuries, rate of episiotomies and angle of episiotomy achieved while using the Episcissors-60 were recorded.

Results: A total of seven studies were identified, five of which were included in the review. A total of 3509 women of whom 1050 had episiotomies performed. Included studies demonstrated that introduction of Episcissors-60, when combined with other preventative measures including manual perineal support at delivery, can reduce Obstetric Anal Sphincter Injuries by up to 50%. In all studies, operators were able to consistently achieve post-suturing episiotomy angles of more than 40°. An increase in episiotomy rates, especially during spontaneous vaginal deliveries, was also reported.

Conclusion: The results of this systematic review support the use of Episcissors-60, combined with other preventative measures, to reduce the incidence of Obstetric Anal Sphincter Injuries.

Keywords: Episcissors-60; Episiotomy; Obstetric Anal Sphincter Injury.

Publication types

  • Systematic Review

MeSH terms

  • Anal Canal / injuries*
  • Episiotomy / instrumentation*
  • Female
  • Humans
  • Obstetric Labor Complications / prevention & control*
  • Perineum / injuries*
  • Pregnancy
  • Risk Factors