عوارض و عوامل مرتبط با اپي زياتومي در زنان نخست زا مراجعه كننده به بيمارستان‌هاي شهر تهران: مطالعه طولي به مدت سه ماه

COMPLICATIONS AND RELATED FACTORS IN EPITHELIAL ZYATVMY PRIMIPAROUS REFERRED TO HOSPITALS IN TEHRAN: A LONGITUDINAL STUDY FOR THREE MONTHS

پيش زمينه و هدف: بهترين فن اپيزياتومي و منافع باليني آن تا حد زيادي ناشناخته مانده است. هدف از اين مطالعه تعيين شيوع نوع اپي زياتومي وتبعات وعوامل مرتبط با آن در طي سه ماه پس از زايمان ميباشد. مواد و روشها: اين مطالعه با طراحي مشاهده اي و طولي در بيمارستان هاي آموزشي شهر تهران انجام شد.تعداد نمونه ها 510 خانم نخست زا با زايمان طبيعي بود. داده ها به وسيله مصاحبه پس از زايمان ودرد پس از نزديكي پس از زايمان اخذ شد. اطلاعات توسط نرم افزار SPSS جهت تجزيه وتحليل استفاده گرديد. يافته ها: شيوع اپيزياتوميدراين پژوهش 97/3 درصد برآورد شد 32/3 درصد اپيزياتومي نوع مدين و 67/7 درصد نوع مديولترال دريافت كردند . عوارض اپي زياتومي عبارتند از درد پرينه و ديسپاوني بحث و نتيجه گيري: شيوع اپي زياتومي در ايران بسيار بيشتر از ميزانهاي گزارش شده از ساير نقاط دنيا ميباشد و شيوع اپي زياتومي مديولترال در ايران عليرغم مشكلات آن بيشتراز اپي زياتومي مدين ميباشد. فراواني درد پرينه نشان داد كه درد پرينه در 24 ساعت اول با تعداد استريا، نوع اپي زياتومي، وزن نوزاد و درد پايدارپرينه(بعد از 40 روز) با طول فاز اول زايمان ارتباط دارد

Background & Aims: Episiotomy is one of the most commonly performed procedures in obstetrics approximately 33%of women giving vaginally in 2000 had an episiotomy, but the best technique of episiotomy and its clinical benefits remain largely unknown. The aim of this study is define episiotomy prevalence and its clinical complication in women who gave birth vaginally in academic hospitals in Tehran. Materials & Methods This was a prospective longitudinal study of parturient at 1,10 , 40 and 90 days post partum.510 primiparous women were followed up, primary outcome was the frequency of perineal pain on days of interview second outcomes were determine effective factors of perineal pain.research data about perineal pain after episiotomy that was conducted at ten academic hospitals in Tehran. This study included 510 primiparous women who gave birth vaginally. Data was collected with interview in 24 h, 10, 40and 90 day after delivery and after collecting information and filling forms , data was analyzed by SPSS11.5 and tests such as chi - square ,independent sample T-test and Mann-Whitney. Results: episiotomy was performed in the 97.3%of primiparous women who gave birth vaginally.32.3%of women had midline episiotomy and 67.7%had mediolateral episiotomy. Episiotomy complication included: perineal pain was reported by 96.4%at 24 h, 63%at 10, 25% at 40 and12% at 90 days. dyspareunia in 10, 40 and 90 day after delivery was reported100%, 66%and 31.2%. preneal pain hadsignificantly related with maternal age in tow time ,the first day(p < 0.023)and the tenth day(p < 0.014),the number of steria in the first day(p < 0.044),active phase duration in the fourth day (p < 0.002). Conclusion: The frequency of preneal pain among the women during the third time of postpartum is equal by foreign research. The number of steria and active phase duration are new influence factor that this survey find and need to more study abut these.