Episiotomy at a tertiary hospital in South-South, Nigeria: A 3-year review

Obodo DU1, Makinde OI1, Ozori ES1*
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
*Correspondence: Dr. Ebiogbo S. Ozori; +234 8065876000; E-mail: ozoriniseod@yahoo.com

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Abstract

Background: Routine episiotomy during the second stage of labour is no longer recommended. Instead, the World Health Organisation (WHO) recommends an episiotomy rate of 10 % of spontaneous vaginal deliveries. Assessment of hospital episiotomy practice is necessary to meet WHO recommendation.
Objectives: To determine episiotomy rate, the pattern of use of episiotomy in parturients, to make an evidence-based recommendation on the use of episiotomy and to provide a background for related studies at the Federal Medical Centre, Yenagoa.
Materials and Methods: This is a 3-year retrospective descriptive study of vaginal deliveries at Federal Medical Centre, Yenagoa, from 1st January 2015 to 31st December 2017. Relevant data were extracted from the labour ward register, including parity, gestational age at delivery, administration of episiotomy, state of perineum after delivery and birth weight. Analysis was done using IBM SPSS version 20.0. Frequencies and percentages of categorical variables are presented in tables.
Results: Of 2,347 women who had vaginal delivery during the study period, 210 had episiotomy, giving an episiotomy rate of 8.9 %. All the episiotomies were medio-lateral. Fifty-one (25.9%), 158 (8.2%) and 1 (0.4%) of nulliparous, multiparous and grandmultiparous women respectively had episiotomy. Episiotomy was given in 47 (31.8 %) and 206 (10 %) of parturients with macrosomic babies (birth weight ≥ 4kg) and term babies respectively and in 4 (1.3%) of parturients with preterm babies. Perineal tear rate was 26.3%; limited to 1st and 2nd degree tears.
Conclusion: The episiotomy rate at the Federal Medical Centre, Yenagoa is much lower than rates recorded in other hospitals in Nigeria. More episiotomies were performed in nulliparous women and during delivery of macrosomic babies. Low episiotomy rate may result in more perineal tears; however, it can achieve a low overall incidence of perineal trauma without an increased incidence of 3rd and 4th degree perineal tears. 

Keywords: Episiotomy, Perineal tear, Episiotomy rate, medio-lateral episiotomy, Midline episiotomy, J-shaped episiotomy.

Cite this article: Obodo DU, Makinde OI, Ozori ES. Episiotomy at a tertiary hospital in South-South, Nigeria: A 3-year review. Yen Med J. 2021;3(3):166–171.

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