COMPARISON OF THE FREQUENCY OF PERINEAL TEARS WITH AND WITHOUT EPISIOTOMY IN PRIMIGRAVIDA FEMALES UNDERGOING VAGINAL DELIVERY AT TERM

Abstract

Objective

To compare the post-delivery complications and recovery between a primigravida (first-time mother) who delivered vaginally without episiotomy and one who delivered vaginally with episiotomy.

Methodology

A prospective cohort study was done in the Department of Obstetrics and Gynaecology Departments of Imran Idress Teaching Hospital/ Islam Teaching Hospital from September 2024 to February 2025. Sixty-two primigravidas who were delivered during term in the same delivery room participated in the study with non-probability consecutive sampling technique. The episiotomy and no-episiotomy groups were split into equal parts. The structured questionnaire and the Likert scale were used to obtain data regarding pain, recovery, mobility problems, infection and satisfaction after delivery. Means and standard deviations were used to report quantitative variables and frequency and percentages were used to report qualitative variables. The data were analysed using the chi square (χ2) test in SPSS version 25 with a p value of < 0.05 regarded as statistically significant.

Results

Women who had episiotomy experienced significantly more pain and complications after childbirth than women who did not have episiotomy. Of the women who had episiotomy, 74.2% experienced significant pain after delivery, while, no women who did not have episiotomy experienced any significant pain (p < 0.001). For women undergoing episiotomy, it was also common practice to experience slow healing and complications arising from the wounds. Stratified analysis revealed differences in pain level based on gestational age, age at birth, baby's weight, and mode of delivery but episiotomy was the most important factor.

Conclusion

Among primigravida women, use of an episiotomy was linked to higher rates of postpartum pain, recovery time, and complications of the wound. It can be concluded that the use of episiotomy may be selective rather than routine, if there are gains to be made in terms of maternal recovery and reducing unnecessary postpartum morbidity after vaginal delivery.