Comparison of Episiotomies and Perineal Laceration with regards to Maternal and Fetal Characteristics: A Three-year Review

Résumé

Background: Episiotomy is a surgical incision done on the perineum during childbirth to prevent trauma in form of tear/ laceration. This birth trauma could result in complication for both the mother and baby. The severity of the trauma varies and depends on maternal and fetal characteristics. The aim of the study was to compare the similarities and differences between Episiotomy use and Perineal Laceration with regards to Maternal and fetal characteristics following vagina delivery among women in Northern Nigerian.
Methods: The study was a retrospective data analysis of all women who had vaginal delivery assisted by medio-lateral episiotomy or had perineal first or second degree perineal lacerations at a Northern Nigerian tertiary hospital in a 3-year duration. The annual records were reviewed and Data on socio-demographic variables, episiotomy use, perineal lacerations, and maternal and fetal characteristics were recorded.
Results: Of 3734 vaginal deliveries, 742 (19.9%) had episiotomies and 482 (12.9%) had first and second degree perineal lacerations. Mean maternal age was 24.7 years for those with episiotomy and 29.8 year for those who had lacerations. The mean birth weight of infants for those who had episiotomy and laceration were not significantly different, being 3 and 3.2kg respectively (p value= 0.58). There was no significant association between episiotomy use or laceration with maternal parity and fetal weight however, there was a significant association between episiotomy and operative vaginal delivery (forceps and vacuum), as well as a significant association between lacerations and assisted breech delivery (p value= 0.01).
Conclusion: Episiotomy use does not differ significantly from perineal laceration in terms of maternal and fetal characteristics, the high rate of episiotomy use especially, among the Primigravidae despite the policy on restriction, requires re-orientation of providers.