Maternal Morbidity in Spontaneous Vaginal Delivery With and Without Episiotomy in Primigravida

INTRODUCTION: Episiotomy, incision of the perineum at the time of vaginal childbirth, is a common surgical procedure experienced by women. Restricted use of episiotomy was associated with more trauma to the anterior perineum which is associated with lesser morbidity and less trauma to the posterior perineum. AIM OF THE STUDY: To study the maternal effects where episiotomy is routinely performed versus without episiotomy in spontaneous vaginal delivery in primigravida. METHODOLOGY: Prospective observational study. Sample size was 400.Study period was 1 year. Women fulfilling the inclusion criteria during the study period were allocated at random to either routine episiotomy group or to non episiotomy group. Data was collected by carefully conducting deliveries. After the delivery of the baby apgar scpore, perineal status, complications of delivery, duration of hospital stay and other maternal morbidities were compared between two groups. RESULTS: Perineal Tears: In our study, Intact perineum rate in non-episiotomy group observed about 8% and first degree perineal tear observed in non-episiotomy group is 29% Second degree perineal tear 22% observed in episiotomy group and 20% in non-episiotomy group. Third degree perineal tear is about 11% in episiotomy group and 9.5% in non-episiotomy group and 4th degree perineal tear 2% on episiotomy group and 1.5% in non-episiotomy group. On comparison of persistent pain status between episiotomy and non-episiotomy study groups, the persistent pain incidence was found to be on the higher side in episiotomy group compared to non- episiotomy group (28 percentage points higher). This trend of significantly higher incidence of persistent pain in episiotomy group subjects was found to be 51% higher than non-episiotomy group subjects. Wound infection will observed 16% in episiotomy group 8% in non episiotomy group.