Post Episiotomy Physical and Physiological Morbidities in Al Azhar University Hospital of Assiut -Upper Egypt

Abstract

SOJ Gynecology, Obstetrics and Women's Health Open AccessResearch Article perineal tears was advocated as a benefit of routine episiotomy in primiparous women [5].In the United States, there has been a steady decline in episiotomy rates from 62% in 1987 to 30 -35 % in 2003 [6].Episiotomy, actually increased rates of perineal infection, blood loss, pain during healing, negatively affected body image issues and sexual function, and incidence of injuries to the anal sphincter with subsequent increased risks of incontinence of flatus and fecal material. Multiple studies demonstrated that the routine use of episiotomy did not protect against pelvic relaxation or fetal intracranial hemorrhage [5].Episiotomy may increase perineal pain during postpartum recovery, resulting in trouble defecating, particularly in midline episiotomies. In addition it may complicate sexual intercourse by making it painful and replacing erectile tissues in the vulva with fibrotic tissue [7]. Women who underwent episiotomy reported more painful intercourse and insufficient lubrication 12-18 months after birth, but did not find any problems with orgasm or arousal [8]. Patients and MethodsThis is a prospective case control study conducted on 400 full term pregnant women (primi &second gravidae) from attendants of delivery ward of Obstetrics and Gynecology department of AlAzhar university hospital of Assiut governorate of Upper Egypt. The study was approved by the Regional Committee for Medical and Health Research Ethics of Al Azhar University of Assiut. Pregnancy was singleton term without underlying medical or any pregnancy-related complications for whom spontaneous vaginal delivery was performed.Women were allocated into 2 equal groups (200 for each) according to whether or not episiotomy was performed (Group I = with episiotomy) and (Group II= without episiotomy). An informed signed written consent was obtained from all participants.During intrapartum period, the same standard obstetrical managements were provided in both groups. Each group was AbstractBackground: Episiotomy is performed as one of the most common surgery procedure to facilitate delivery and prevent complications of hard labour in both mother and her neonate. Routine episiotomy is a controversial issue among obstetricians.