Methods	Generation method of randomization not established. Concealment allocation method not established. ’Allocated randomly’.
Participants	181 women primigravid, vaginal delivery, at least 16 years old, no less than 38 weeks’ gestational age, not suffering from any important medical or psychiatric conditions or eclampsia
Interventions	One group were not to undergo episiotomy unless it was considered to be medically essential by the person in charge, that is the accoucheur could see that a woman was going to sustain a greater damage or if the intact perineum was thought to be hindering the achievement of a safe normal or operative delivery Another group were to undergo mediolateral episiotomy.
Outcomes	Severe maternal trauma. Any posterior perineal trauma. Need for suturing perineal trauma
Notes	Mediolateral episiotomies. Epsiotomy rates were 7.6% for restricted group and 100% for the routine group
Risk of bias
Bias	Authors’ judgement	Support for judgement
Allocation concealment (selection bias)	Unclear risk	B - Unclear