Prevalence of Episiotomy and Its Associated Factors in University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Study from Ethiopia
American Journal of Life Sciences
Volume 8, Issue 1, June 2020, Pages: 9-13
Received: Oct. 23, 2019;
Accepted: Apr. 23, 2020;
Published: Apr. 29, 2020
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Yonas Teshome, Department of Biomedical Science, College of Medicine, Debre Birhan University, Debre Berhan, Ethiopia
Mengistu Mekonen, Department of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Tariku Sisay, Department of Biomedical Science, College of Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
Getahun Chala, Department of Physiology, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
Amanuael Mengistu, Department of Internal Medicine, Debre Berhan Hospital, Debre Berhan, Ethiopia
Sisay Shewasinad, Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
Negese Worku, Department of Biomedical Science, College of Medicine, Debre Birhan University, Debre Berhan, Ethiopia
Background: Episiotomy is a surgical incision of the perineum during delivery to enlarge the vaginal orifice. It is one of the most commonly performed obstetric intervention world widely. The magnitude of episiotomy varies from population to population. Limited information exists related to the practice of episiotomy in Ethiopia. This study aimed to assess the prevalence of episiotomy and its associated factors in University of Gondar Comprehensive Specialized Referral Hospital, Ethiopia. Methods: Institution based retrospective cross-sectional study was undertaken from March to June 2014 on 306 mothers who had a vaginal delivery in the Hospital. Systematic random sampling technique was employed to select study units. The data were collected using pretested cheek list. Proportion of patients who had episiotomy was calculated and the association between dependent and independent variables was checked using both binary and multiple logistic regression and Chi-square. Results: Prevalence of episiotomy in University of Gondar Comprehensive specialized Referral Hospital was 47.7% (n = 146). Majority (89.5%) of the delivery was spontaneous vaginal delivery while vacuum, forceps and destructive delivery were 4.6%, 4.6%, and 1.3% respectively. During pregnancy and delivery, 84% of mothers had no associated diseases while 8% had hypertensive disorder, 5% diabetes mellitus and 3% of them has other diseases. After multivariate analysis episiotomy was significantly associated with maternal age (15-24 years) (p = 0.041, AOR (CI 95%) 1.65 (1.02 - 2.66)), primiparity (p =0.010, AOR (CI 95%) 2.61 (1.54 - 4.44)), prolonged labor (p = 0.001, COR (CI 95%) 6.45 (2.89 - 14.38)), and weight of newborn (p = 0.044, COR (CI 95%) 2.48 (1.16, 5.31)). Conclusion: Prevalence of episiotomies in the institution was 47.7% and variables that remained associated significantly with episiotomy were maternal age, primiparity, prolonged labor, and newborn weight.
Prevalence of Episiotomy and Its Associated Factors in University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Study from Ethiopia, American Journal of Life Sciences.
Vol. 8, No. 1,
2020, pp. 9-13.
Carroli G and Mignini L. Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2012; (1). doi: 10.1002/14651858.CD000081.pub2.
Klein M. Rites of Passage: Episiotomy and the Second Stage of Labour. Can Fam Physiology. 1988; 34: 2019-2025.
Lappen, J. R., and Gossett, D. R. Changes in episiotomy practice: Evidence-based medicine in action. Expert Review of Obstetrics and Gynecology. 2010; 5 (3): 301-309.
Bertozzi S, Londero A, Fruscalzo A et. al. Impact of episiotomy on pelvic floor disorders and their influence on women’s wellness after the sixth month postpartum: a retrospective study. BMC. Women’s Health. 2011; 11: 12.
Kumar S, Singh S, Babu K M, Halesha B, and Vikas S. Restricted use of Episiotomy. J Obstet Gynecol India. 2010; 60 (5): 408 – 412.
Kutuk M, Dolanbay M, Ozgun M, Ozdemir F, Ozturk A, and Aygen E. Retrospective Analysis of Episiotomy Rate in Erciyes University. Gynecol Obstet Reprod Med. 2014; 20: 10-14.
Sayasneh A and Pandeva I. Postpartum sexual dysfunction: a literature review of risk factors and role of mode of delivery. BJMP. 2010; 3 (2): 316-321.
Signorello, L. B. Midline episiotomy and anal incontinence: retrospective cohort study. BMJ, 2000; 320 (7227): 86–90. doi: 10.1136/bmj.320.7227.86.
Alzahrani H. Does episiotomy prevent perineal trauma? MIDIRS Midwifery Digest. 2014; 24 (4): 478–483.
Hsieh W, Liang C, Wu D, Chang S, Chueh H, and Chao A. Prevalence and contributing factors of severe perineal damage following episiotomy-assisted vaginal delivery. Taiwanese Journal of Obstetrics & Gynecology. 2014; 53: 481-485.
Raisanen S, Julkunen K, and Heinonen S. Need for and consequences of episiotomy in vaginal birth: a critical approach. Midwifery. 2010; 26: 348–356.
Langrová P, and Vrublová Y. Relationship between episiotomy and prevalence of urinary incontinence in women 2-5 years after childbirth. Cent Eur J Nurs Midw 2014; 5 (3): 94-98.
Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J, and Lohr K. Outcomes of Routine Episiotomy: a systematic review. JAMA. 2005; 293: 2141-2148.
Melo I., Katz L., Coutinho I., and Amorim M. Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial. Reproductive Health. 2014; 11 (1). doi: 10.1186/1742-4755-11-66.
Fodstad K, Staff A and Laine K. Effect of different episiotomy techniques on perineal pain and sexual activity 3 months after delivery. Int Urogynecol J. 2014. doi: 10.1007/s00192-014-2401-2.
Fodstad K, Laine K and Staff A. Different episiotomy techniques, postpartum perineal pain, and blood loss: an observational study. Int Urogynecol J. 2014. doi: 10.1007/s00192-012-1960-3.
Allen R and Ronald. Hanson W. Episiotomy in Low-Risk Vaginal Deliveries. J Am Board Fam Pract. 2005; 18: 8–12.
Otoide V, Ogbonmwan S, and Okonofua F. Episiotomy in Nigeria. International Journal of Gynecology & Obstetrics. 2000; 68: 13-17.
Carvalho C, Souza A, and Filho O. Prevalence and factors associated with practice of episiotomy at a maternity school in Recife, Pernambuko, Brazil. Rev Assoc Med Bras. 2010; 56 (3): 333-339.
Marai W. A two years retrospective review of episiotomy at Jimma Teaching Hospital, southwestern Ethiopia. Ethiop Med J. 2002; 40 (2): 141-148.
Frankman EA, Wang L, Bunker CH, et al. Episiotomy in the United States: has anything changed? Am J Obstet Gynecol. 2009; 200: 573-573.
Amorim M, Franca-Neto A, Leal N, Melo F, Maia S, and Alves J. Is It Possible to Never Perform Episiotomy During Vaginal Delivery. Obstetrics & Gynecology. 2014; 123: 38.
Trinh, A, Khambalia A, Ampt A, Morris J and Roberts C. Episiotomy rate in Vietnamese-born women in Australia: support for a change in obstetric practice in Viet Nam. Bull World Health Organ. 2013; 91: 350–356. doi: http://dx.doi.org/10.2471/BLT.12.114314.
Leal N, Amorim M, Franca-Neto A, Leite D, Melo F, Alves J. Factors Associated With Perineal Lacerations Requiring Suture in Vaginal Births Without Episiotomy Obstetrics & Gynecology. 2014; 123: 63–64. doi: 10.1097/01.AOG.0000447369.00977.4c.
Steiner N., Weintraub A. Y., Wiznitzer, A. et al. Episiotomy: the final cut? Arch Gynecol Obstet. 2012; 286: 1369. doi: 10.1007/s00404-012-2460-x.
Manzanares S, Cobo D, Martínez M, Mar Sánchez G, and Pineda A. Risk of episiotomy and perineal lacerations recurring after first delivery. Birth. 2013; 40 (4): 307–311. doi: 10.1111/birt.12077.
Dame J, Neher J and Safranek S. Does antepartum perineal massage reduce intrapartum lacerations. Journal of family practice. 2008; 57 (7): 480-481.
Ho J, Pattanittum P, Japaraj R, Turner T, Swadpanich U, and Crowther C. Influence of training in the use and generation of evidence on episiotomy practice and perineal trauma. International Journal of Gynecology and Obstetrics. 2010; 111: 13–18.