[Episiotomy--obstetrics operation with strict indications or iatrogenic injury of the female pelvic floor].

Episiotomy is the most common operation in obstetrics, which took its place in the obstetric's practice a long ago. According to hospital protocols or doctor's habits nowadays form 9.5 to 95% of delivering woman will have episiotomy. These results are not based on difference of process or mechanism of delivery. And in that case it seems that the true is at least somewhere between both results. Unfortunately the indications about episiotomy, described in obstetrics books, are not according "evidence-based" medicine results, but only supposing positive and negative results for the pregnant woman. Current indications for performing the episiotomy, based on the lot of researches, are fetal distress syndrome, complicated vaginal delivery (instrumental, breech or occipito-posterior delivery) and scar from poor-healed old 3rd or 4th degree rupture of the perineum.