Is it time to abandon episiotomy use? A randomized controlled trial (EPITRIAL).

Introduction And Hypothesis: The objective of this trial was to evaluate whether avoidance of episiotomy can decrease the risk of advanced perineal tears.

Methods: In this randomized (1:1) parallel-group superiority trial, primiparous women underwent randomization into "avoidance of episiotomy" (the study group in which episiotomy was allowed only in cases of fetal distress) or "standard care." The primary outcome was the incidence of advanced (3rd- and 4th-degree) perineal tears.