This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Operative Obs, Subject name: Gynaecology & Obstetrics
As compared to mediolateral episiotomy, median episiotomy has complications because of: 
Select and explain. 
A. Poor repair, B. Cosmetic problem, C. Extension to rectum, D. More blood loss
C: Extension to rectum
Answer: C: Extension to rectum 
Explanation: Ans. (c) Extension to rectumRef.: D.C. Dutta 8th ed. / 649-50, 5th ed.l 606* Episiotomy: is defined as a surgical incision of the perineum made to increase the diameter of the vulval outlet during child- birth (and not the whole birth canal).* Types of episiotomy: (Only the median or mediolateral episiotomy are done commonly).* Medio-lateral# Median# Lateral# T shapedMedianMediolateral* Muscles are not cut* Blood loss is less* Repair is easy* Healing is superior* Dyspareunia is rare* Extension, if occurs, may involve rectum* Incision cannot be extended* Muscles are cut* Blood loss is more* Repair is difficult* Healing is less superior* Dyspareunia is more* Relative safety from rectal involvement from extension* Incision can be extended Q