The reaction of the cardiovascular system to terrain cure in patients with ischemic heart disease who have undergone surgical myocardial revascularization]

The purpose is to asses the effect of restrictive use of mediolateral episiotomy on the spontaneous laceration of the low birth canal. The material includes 613 labors some of which gave birth with indication for episiotomy and control group of 441 retrospective cases with routine management of the second period of labor. The restrictive use of episiotomy decreases the rate from 45.6% in the routine practice to 32.8%. The reduced rate of episiotomy has as a consequent increase rate of second degree perineal laceration adn insignificant increase of vaginal lacerations. The management of restrictive and liberal use of mediolateral episiotomy has not effect on third and four degree perineal laceration, on the accessory tears of the vagina and on the rate of perineotomy. If from all labors are subtracted operative deliveries, surgical intervention for repairing the laceration of the birth canal and pathology of the placental period the rate of labors without any intervention is only 13.3%. Our results suggest that labor nowadays is operative activity.