Comparison of episiotomy rates, practice of analgesia and the maternal complications within first 24 hours at two tertiary care units: a comparative, descriptive and a retrospective study

Abstract

Objectives: Estimate the episiotomy rates at two tertiary care units. Find out the practice of analgesia, prior to performing the episiotomy at the two units. Find out the maternal complications within the first 24 hours after episiotomy at the two units. Compare the outcomes at the two units. Method: Data collected from medical records of all normal vaginal deliveries (NVD); from 21st April to 20th May 2011 at Anuradhapura Teaching Hospital (ATH) and 20th March to 20th May 2012 at labour room C, Castle Street Hospital for Women (CSHW).Results: The episiotomy rate at ATH was 59%, rate of 85% for primiparous women and a rate of 29.9% for multiparous women. The episiotomy rate at CSHW was 96.5%, a rate of 97.8% for primiparous women and a rate of 94% for multiparous women. All were medio-lateral episiotomies. Except for two women at CSHW who had epidural analgesia in labour, none of the other women had effective analgesia prior to performing episiotomies at both units. All women had 1% - 2% lignocaine infiltrations prior to repair of episiotomy at both the above units. The complications documented within 24 hours due to episiotomy at both units were haematomas, re-suturing, vaginal pack insertions and anaemia.Conclusion: Episiotomy rate at CSHW was significantly higher than ATH. However at both units the episiotomy rates were higher than the recommended rates and there was no significant difference in the rate of complications at the two units. DOI: http://dx.doi.org/10.4038/sljog.v35i1.5997 Sri Lanka Journal of Obstetrics and Gynaecology 2013; 35: 10-15