Avoidance of Routine Use of Episiotomy in Primigravida
DOI:
https://doi.org/10.15218/zjms.2009.011Keywords:
Episiotomy, perineal tears, wound infection, dyspareuniaAbstract
Background and objective: The justification of the routine use of the episiotomy arouse at the beginning of 20th century. It was based on personal beliefs without scientific basis and this led to the incorporation of episiotomy in daily practice . High-quality methodological studies gave strong evidence that episiotomy should not be done routinely. The purpose of this study was to find out the rate and degrees of perineal tear in women with versus without episiotomy and to evaluate the severity of pain and complications including wound infection, wound dehiscence and dyspareunia.
Methods: This is a prospective interventional study included 200 primigravida with term pregnancy, who attended the labor room at Maternity Teaching Hospital from 1st of January 2008 till 1st of July 2008. Episiotomy was done for a group and avoided in another group, then follow up was done to evaluate complications.
Results: Perineal tears were significantly more in patients with episiotomy as episiotomy itself is regarded as second degree perineal tear. There was significant difference in the severity of pain, wound infection and dyspareunia among both groups but there was no significant difference in the Apgar score of the newborn in both group.
Conclusion: This study does not supports maternal benefits of routine episiotomy.
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References
Ronnie Falcao, (2004). Benefits and risks of episiotomy: A review of the English-language literature, Obstet Gynecol Survey ; 50: 821-835.
Graham ID, Graham DF, (1997). Episiotomy counts: trends and prevalence in Canada. Birth; 24: 141-7.
RCOG guideline No.23, (2004). Methods and Materials used in Perineal Repair, Royal College of Obstetricians and Gynaecologists.
Lucy Kean. (2004). Perineal trauma. In: David M. Luesley and Philip N. An evidence-based text for MRCOG. Chapter (36); 427-435.
Hofmeyr GJ, Hodnett ED, Gates S, Sakala C, (2003). Continuous support for women during childbirth. Cochrane Database Syst Rev; CD002006.
Cunningham F.Gary, Kenneth J. Leveno, Steven L. Bloom, John C. Hauth, Larry C. Jilstrap, Katharine D. Wenstrom. (2005). Wlliams Obstetrics. 22nd ed, Vol. (1); 435-8.
Rockner G, (1990). Urinary incontinence after perineal trauma at childbirth. Scand J Caring Sci; 4 (4): 169-72.
Katherine Hartmann, Meera Viswanathan, Rachel Palmieri, Gerald Gartlehner, John Thorp, Kathleen N. Lohr, (2005). Outcomes of Routine Episiotomy: A Systematic Review JAMA; 293: 2141-2148.
Carroli G, Belizan J, (2005). Episiotomy for vaginal birth. Cochrane Database Syst Rev; CD000081.
Lily-Scott Formato, (1985). Routine prophylactic episiotomy is always necessary; Vol.(30), No.(3).
Gass MS, Dunn CD, and Stys SJ, (1986). Effect of episiotomy on the frequency of vaginal outlet lacerations. J Reprod Med; 31(4); 240-244.
Lam K W, (2006). The practice of episiotomy in public hospitals in Hong Kong; 12: 94-8.
Thranov I, Kringelbach AM, Melchior E, Olsen O, Damsgaard MT, (1990). Episiotomy or tear at vaginal delivery, Acta Obstet Gynecol Scand; 69: 11-15.
Dannecker C, Hillemanns P, Strauss A, et al, (2004). Episiotomy and perineal tears presumed to be imminent: Randomized controlled trial. Acta Obstet Gynecol Scand; 83: 364-8.
Larsson PG, Platz-Christensen JJ, Bergman B, Wallstersson G, (1991). Advantage or disadvantage of episiotomy compared with spontaneous perineal laceration. Gynecol Obstet; 31: 213-216.
Klein M.C, Gauthier R.J, Robbins J.M, Kaczorowski J. Jorges S.H, Franco E.D., et al. (1994). Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. Am J Obstet Gynecol; 171: 591-598
Karacam Z, Eroglu K, (2003). Effects of episiotomy on bonding and mothers' health. J Adv Nurs; 43(4): 384-94.
Klein MC, Gauthier RJ, Jorgensen SH, et al, (1992). Does episiotomy prevent perineal trauma and pelvic floor relaxation? Online J Curr Clin Trials ; Doc No 10.
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Copyright (c) 2009 Trifa Ahmed Hamda, Ghada S. Alsakkal (Author)
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