••• Chapter 6^ Operative Obstetrics Pearls^69
❍ True or False: Episiotomy has been identified as an independent risk factor for dyspareunia or delayed
return to sexual activity when compared with equally severe perineal trauma in women who did not have
an episiotomy.
False.
❍ True or False: Restricted use of episiotomy is preferable to routine use of episiotomy.
True.
❍ True or False: Mediolateral episiotomy is associated with higher rates of injury to the anal sphincter
and rectum than is median episiotomy.
False.
❍ True or False: Currently the major known benefit of routine episiotomy helps to prevent pelvic floor damage
leading to incontinence.
False.
❍ True or False: To avoid anal sphincter or rectal injury, mediolateral episiotomy is superior to median
episiotomy.
True.
❍ True or False: According to the ACOG practice bulletin, the fetal benefits of episiotomy include cranial
protection, especially for premature infants, reduced perinatal asphyxia, less fetal distress, and better
Apgar scores.
False. None of the above are benefits of episiotomy.
❍ True or False: Operative vaginal delivery is contraindicated if the fetus is known to have osteogenesis
imperfecta.
True.
❍ True or False: Operative vaginal delivery is contraindicated if the fetus is known to occiput posterior.
False.
❍ True or False: Operative vaginal delivery is contraindicated if the fetus is known to have alloimmune
thrombocytopenia.
True.
❍ True or False: Operative vaginal delivery is contraindicated if the fetus is known to have von Willebrand
disease.
True.
❍ True or False: Comparing fetuses delivered by cesarean delivery during labor versus fetuses delivered
by cesarean delivery after attempted vacuum or forceps the relative risk of intracranial hemorrhage
is approximately three times greater.
True.