Author/Authors :
Aram, Shahnaz Associate Professor, Department of Obstetrics and Gynecology - School of Medicine, Isfahan University of Medical Sciences , Danesh Shahraki, Azar Associate Professor - Department of Obstetrics and Gynecology - School of Medicine, Isfahan University of Medical Sciences , Pourkabirian, Soodabeh Gynecologist - Department of Obstetrics and Gynecology - School of Medicine, Isfahan University of Medical Sciences , Choupannejad, Shekofeh Gynecologist - Department of Obstetrics and Gynecology - School of Medicine, Isfahan University of Medical Sciences , Khodaee, Sepideh Resident - Department of Obstetrics and Gynecology - School of Medicine, Isfahan University of Medical Sciences
Abstract :
BACKGROUND: Routine episiotomy is a controversial issue among gynecologists. The aim of this study was to compare
early maternal and neonatal complications of restrictive episiotomy and routine episiotomy in primiparus vaginal
delivery.
METHODS: In this descriptive cross-sectional study, two groups of primiparus normal vaginal delivery (NVD) cases
with routine and restrictive episiotomy were studied. Immediately and in the first 24 and 48 hours after delivery, specific
charts were used to compare the two groups in terms of perineal laceration size, neonatal Apgar score and postdelivery.
For data analysis, SPSS was used to conduct student t-test and Kruskal-Wallis test. A p-value < 0.05 was considered
significant.
RESULTS: Forty primiparus pregnant women were studied in each group. Episiotomy was performed in 7.5% of the restrictive
group. Perineal laceration was measured as 3.68 ± 0.47 cm and 1.21 ± 1.1 in routine and restrictive episiotomy
groups, respectively (p < 0.05). Intact perineum or first-degree laceration was seen in 80% of the restrictive group.
However, second- and third-degree laceration were respectively observed in 75% and 15% of the routine episiotomy
group (p < 0.05). Pain relief (immediately, 24 and 48 hours after delivery) was significantly higher in the restrictive
group (p < 0.05). On the contrary, no significant difference in Apgar scores at the first and fifth minutes after birth was
found between the two groups (p > 0.05).