International Journal of Research in Medical Sciences | April 2015 | Vol 3 | Issue 4 Page 836
International Journal of Research in Medical Sciences
Owa OO et al. Int J Res Med Sci. 2015 Apr;3(4):836-840
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Research Article
Factors associated with episiotomy among parturients delivering
in a tertiary care centre in Nigeria
Olorunfemi Oludele Owa
1
*, Akinbowale Romance Eniowo
2
, Olayinka Stephen Ilesanmi
3
INTRODUCTION
Episiotomy is defined as surgical incision of the
perineum to facilitate delivery.
1
The surgical incision
made into the perineum- the region between the vagina
and the anus- to widen the vaginal opening for delivery
was introduced as an obstetric procedure in the eighteenth
century,
2
was first reported as far back as 1741.
3
The
complications of perineal trauma following childbirth
include hemorrhage, haematoma and abscess formation,
perineal pain and discomfort, fistula formation,
dyspareunia and anal incontinence. In addition, there has
been an increase in ligation related to the complications
of perineal trauma following childbirth.
1
It is a well-documented fact that episiotomy is the most
commonly performed procedure in obstetrics.
1,4-6
A policy of routine episiotomy was widely practiced at
the turn of 20
th
century. This policy led to high rates of
episiotomy in many countries, reaching 30% in Europe,
7
62.5% in the USA,
8
80% in Argentina
9
and about 100%
ABSTRACT
Background: The use of routine episiotomy is now less favoured among obstetricians. Given considerable evidence,
it use increases maternal morbidity without evidence to support maternal or neonatal benefit. Objectives: To
determine the current rate of episiotomy among parturients delivering at Federal Medical Centre, Owo, Ondo State,
Nigeria and to identify factors associated with episiotomy.
Methods: The retrospective study was conducted using the delivery records between 1
st
January 2012 and 31
st
December 2012. Information was obtained from the delivery register and medical records. There were 802 booked
patients who had singleton vaginal deliveries between the studied periods. A total of 728 of these patients’ case
records were obtained for analysis using SPSS 17.
Results: The incidence of episiotomy was 9.3%. Those age <20 years, nulliparous, those who had assisted breech and
instrumental deliveries had more episiotomy (P <0.0001). All the instrumental deliveries and most assisted breech
deliveries (67%) were taken by the doctors. Episiotomies were more common when doctors took deliveries (Doctor
vs. Nurses: 28.6% vs. 5.8%) (P <0.0001).
Conclusion: While this study has identified factors associated with episiotomy, the episiotomy rate remain within
normal rate at the studied centre. It is pertinent that health care providers always bear in mind the standard indications
for episiotomy. This will go a long way in reducing the episiotomy rate and maintaining the recommended WHO rate
of 10%.
Keywords: Episiotomy, Delivery, Parturients, Records, Instrumental deliveries
1
Department of Obstetrics and Gynaecology, Mother and Child Hospital, Akure, Ondo State, Nigeria
2
Department of Obstetrics and Gynaecology, Federal Medical Centre Owo, Ondo State, Nigeria
3
Department of Community Health, Federal Medical Centre Owo, Ondo State, Nigeria
Received: 17 February 2015
Accepted: 08 March 2015
*Correspondence:
Dr. Olorunfemi Oludele Owa,
E-mail: owaolorunfemi@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.5455/2320-6012.ijrms20150403