COMPARATIVE STUDY OF ROUTINE VERSUS RESTRICTED USE OF EPISIOTOMY IN PRIMIGRAVIDAS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 48
Abstract
OBJECTIVES To compare maternal morbidity in routine versus selective episiotomy in primigravidae. STUDY DESIGN Prospective case control study. SETTING AND DURATION OF STUDY Obstetrics and gynaecology ward of Krishna Institute of Medical Sciences, Karad, from November 2013 to June 2015. METHODOLOGY Deliveries managed with routine use of episiotomy formed the Control Group, while those managed with restricted use of episiotomy formed the Study Group. Exclusion Criteria of our study was multigravida, multiple pregnancies, assisted breech deliveries, non-vertex presentations including malposition, instrumental deliveries and associated systemic diseases, maternal exhaustion, preterm deliveries, foetal macrosomia, PROM and VBAC. Perineal Pain Score was measured in the post-partum period by 100 mm VAS (visual analog scale). The main outcome measures which causes maternal morbidity was severe perineal trauma (3rd and 4th degree tears). Other outcomes which cause the maternal morbidity in terms of 1st and 2nd perineal tears, presence of perineal pain, haematoma formation and wound dehiscence were also recorded on proforma. RESULTS This study included 200 patients of routine episiotomy and 200 patients of restricted episiotomy. In the study group, 75% of women had first degree of tear and 22.5% women had second degree tear without any post-partum haemorrhage and in the control group; 95% pregnant women had episiotomy without any extension, 10 pregnant women had third degree of tear. During followup, only 2 patients reported dyspareunia in study group, while 3 patients reported faulty wound healing, 1 patient each reported urinary incontinence and anorectal incontinence, also 4 patients reported dyspareunia among control group. CONCLUSION As perineal pain, perineal tears and wound dehiscence and infections were all less frequent in study group, as compared to routine group, also pelvic muscle strength was better in study group, so overall maternal morbidity was less among study group
Authors and Affiliations
Apurva , Sanjay , Yamini , Rajshree
Keywords
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- EP ID EP96303
- DOI 10.14260/jemds/2016/718.
- Views 88
- Downloads 0
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