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Episiotomy in Nigeria.
V O Otoide1, S M Ogbonmwan, F E Okonofua
1Department of Obstetrics and Gynecology, University of Benin, Nigeria.
Summary
Episiotomy use was high (46.6%) in Nigerian women, particularly first-time mothers. Episiotomy, unlike perineal tears, increased wound breakdown risk, suggesting a need for reduced use and better wound care.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Surgical Outcomes
Background:
- Episiotomy is a surgical procedure during childbirth.
- Perineal tears can occur spontaneously during vaginal delivery.
- Understanding the incidence and complications of both is crucial for maternal care.
Purpose of the Study:
- To determine the incidence of episiotomy and perineal tears.
- To investigate complications associated with episiotomy and tears.
- To analyze factors influencing their occurrence at a Nigerian teaching hospital.
Main Methods:
- Retrospective review of 1345 vaginal births.
- Data collected from January 1997 to December 1998.
- Analysis of episiotomy rates, tear incidence, and associated complications.
Main Results:
- Episiotomy prevalence was 46.6%, exceeding 90% in primigravid women.
- Episiotomy rates decreased with parity, while spontaneous tears increased.
- Episiotomy, compared to tears, showed a higher risk of wound breakdown requiring resuturing.
Conclusions:
- A systematic reduction in episiotomy incidence is recommended.
- Improved patient selection for episiotomy is necessary.
- Enhanced prevention of perineal tears and meticulous episiotomy wound care are essential.