Episiotomy Quick Reference Card: free one-page guide for OB/GYN residents

A one-page quick reference for OB/GYN residents and trainees, made to print and keep on the labour ward.

What is on the card

- When to cut and when not to (NICE NG235, RCOG Green-top 29 and 26)

- The angle: RCOG says 60 degrees when the perineum is distended, NICE says 45 to 60 degrees

- The muscles divided by a right mediolateral episiotomy, with a labelled diagram

- Repair step by step: before you start, three layers, after you finish

- Which thread goes where: Vicryl, PDS, Monocryl

- OASI grades 3a to 4

- A consent checklist you can tick

- The key evidence numbers and a full reference list

You get two files

- PDF: print it on one A4 page

- HTML: open it in a browser to tick the checklist and tap each muscle layer on the diagram

Who it is for

OB/GYN residents, MRCOG candidates and trainees who want the guideline position on one page.

Who made it

Dr Ekram Ghazal, consultant obstetrician and gynaecologist. It is the companion to my video on episiotomy: [on my youtube channel obstetrics and gynecology with Dr. Ekram Ghazal]

Educational use for qualified clinicians and trainees. It does not replace your local protocol or your clinical judgement. Guidance checked October 2026. Please check wording against the original guidelines.