A resident performs a mediolateral episiotomy during the second stage of labor. What is the primary anatomical advantage of this technique over a midline episiotomy?

• A Faster healing
• B Less postpartum pain
• C Better cosmetic outcome
• D Lower risk of extension into the anal sphincter ✓

Explanation

A mediolateral episiotomy cuts the bulbospongiosus and transverse perineal muscles at a 45 to 60 degree angle, reducing the risk of extension into the anal sphincter and rectum compared to a midline episiotomy. Midline episiotomies heal faster with less pain but carry a higher risk of third and fourth-degree extensions.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.