Frequency of Infected Episiotomy in Primigravida Women After Vaginal Delivery

Abstract

Introduction: Episiotomy is a very common procedure executed at the time of normal delivery to avoid perineal tears and lacerations. Its rates vary considerably, ranging from 83% in primigravida to 71% in multigravida. The episiotomy rate in the United States is 50%, in Sweden it is 30%, and in England and Wales it is reported to be 53%. It is primarily used to prevent perineal tears of the third and fourth degrees, thereby preserving the muscles of the perineum. Some research suggests that it may reduce the risk of cerebral trauma in babies. The objective of the study is to find out the frequency of infected episiotomy among primigravida women, as infected episiotomy is rarely studied and these infections can put extra burden not only on hospital resources but also on the patient herself. The study will give us local, fresh evidence of infected episiotomies which will help in making policies for a number of benefits. This, in turn, will reduce posterior perineal trauma, suturing, and the associated complications. It will also decrease the pain due to suturing and the resulting medications taken for vaginal or perineal trauma. Such policies and recommendations will greatly help local gynecologists. Objective: To determine the frequency of infected episiotomy in primigravida women after vaginal delivery Study Settings: Department of Obs & Gynae, MTI-HMC, Peshawar. Duration: From 28 Dec, 2018to 28 Jun, 2019. Study Design: Randomized Control Trial. All patients were subjected to complete history, physical and vaginal examination, and routine investigation, including ultrasound. All patients were prepared for labor. During labor, instrument alassisted delivery was excluded at that very moment. Labor procedures were performed by an expert obstetrician fellow of CPSP with more than five years’ experience. After episiotomy was done, all patients were followed up on the 7th day. The cultures weresent only of the infected patients for confirmation of infected episiotomy having a wound or the are around it becoming a red, painful(VAS Pain Score>5), swollen area, with pus, or foul smell from the wound. Results: The mean and standard deviation foragewas25+3.75. The meanandSDsforGestationalAgewere35+1.53, and 97 (64.23%) patients were between the ages of 18 and 25. In the 2635 years age gap, 54 (35.76%) patients were recorded. In our study, 16 (10.59%) patients had an infected episiotomy. Conclusion: In this study, we concluded that primigravida are more susceptible to having infected episiotomies.