Observation On The Rates, Benefits And Complications Of Episiotomy In A Tertiary Health Institution In Nigeria

This was an observational study undertaken at the University of Benin Teaching Hospital, Benin City from September 1, 2001 to October 31, 2002. The women who delivered per vagina with episiotomy were analyzed and compared with those who delivered without it. Outcome measures were 2nd stage duration, birth weight, Apgar score, perineal tear, perineal pain, dyspareunia and incontinence in the pueperium. There were 1,404 vaginal deliveries and 34.5% of them had episiotomy. Episiotomy was more frequent in nulliparous (65.7%) than multiparous (17.4%) women. The commonest indication for episiotomy was tight perineum (75.2%) followed by vacuum extraction (8.6%), forceps delivery (6.6%), fetal prematurity (4.1%), assisted breech delivery (2.9%) and the delivery of big babies (2.9%). The duration of second stage was not influenced by episiotomy but the Apgar score at one minute was better with episiotomy. Blood loss was more with episiotomy. Perineal tear occurred more in women who delivered without episiotomy. (25.6%vs.4.1%; P=0.0001; OR=12). Dyspareunia was more common after vaginal delivery with episiotomy. Conclusively, episiotomy was associated with a better Apgar score at one minute and it protected against perineal tear. However blood loss at delivery was more with episiotomy. Perineal pain and dyspareunia were commoner with it. Keywords: Episiotomy, Indications, Complications Annals of Biomedical Science Vol. 1 (2) 2002: pp. 141-147