Episiotomy and Its Complications

Mousavi, Seyed Hosein Soleimanzadeh; Miri, Mina; Farzaneh, Farahnaz

doi:10.5812/zjrms.104127

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…The process of episiotomy surgery results in injury and pain of the perineum. Pain due to episiotomy is higher than that of non-episiotomy [5]. More than 90% of perineal pain can occur on the first day of childbirth, and as many as 88% of pain cases will subside within 2 months after childbirth.…”

Section: Introductionmentioning

confidence: 99%

The Episiotomy Effect of Topical Combination of Cinnamon Oil and Red Betel on Skin Wound Healing Mechanism

Emelda¹,

Alfiana²,

Kusumawardani³

et al. 2021

Advances in Health Sciences Research

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The process of episiotomy surgery during childbirth results in injury and pain in the perineum. This study aims to evaluate the effect of the topical combination of cinnamon oil and red betel extract on the healing process of episiotomy incision model in Swiss mice. The research subjects were divided into six groups: (I) Negative control, (II) positive control, (III) mice treated with cinnamon oil, (IV) mice treated with red betel extract, (V) mice treated with 2 ml cinnamon oil and 20% red betel extract, and (VI) mice treated with 4 ml cinnamon oil and 40% red betel extract. Each group of mice received a full-thickness skin wound on the back. The incision wound was then applied by using gel two times a day for 5 days which had been prepared previously. The results showed that the combination of cinnamon oil and red betel decreased the area and percentage of the wound, decreased the inflammatory cell infiltration, and increased the vascular endothelial growth factor expression. This study concludes that the combination of cinnamon oil and red betel extract have the potential to accelerate wound healing and reduce perineal pain in episiotomy incision models conducted in Swiss mice.

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Section: Introductionmentioning

confidence: 99%

The Episiotomy Effect of Topical Combination of Cinnamon Oil and Red Betel on Skin Wound Healing Mechanism

Emelda¹,

Alfiana²,

Kusumawardani³

et al. 2021

Advances in Health Sciences Research

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“…Eskandar et al reported that 65% of perineal tear risks were decreased by the performance of mediolateral episiotomy, which showed an absolute risk reduction of 1.1% [14]. Furthermore, past studies demonstrated that episiotomy was linked to lower APGAR scores [15,16]. Mousavi et al found that mothers who were indicated for episiotomy had infants with significantly lower APGAR scores at both the first and fifth minutes compared to mothers who were not [17].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Case-Control Study of Extended Birth Perineal Tears and Risk Factors

Dendini,

Aldossari,

AlQassab

et al. 2024

Cureus

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Background: A perineal tear is a rupture of the skin or muscle between the vagina and anus (perineum). A third-degree tear is one type of extended perineal tear (EPT), and it involves the penetration of the anal sphincter muscle. Another type of EPT is a fourth-degree laceration, which penetrates deeper into the lining of the anus or rectum. The stretching of the perineum during childbirth may result in perineal trauma. Invasive surgical interventions are required for the treatment of EPTs. For this reason, the reduction of their incidence can be achieved by fully comprehending the risk aspects associated with them.Objective: The aim of this study is to contribute to the body of knowledge by providing insight into the various risk factors that are associated with extended perineal trauma. By following this path, this study aims to contribute to and advance Saudi Arabia's development of evidence-oriented obstetric care recommendations.Study design: The current study is a case-control study where a review of 5000 vaginal delivery records was carried out between March 1, 2018, and March 19, 2023. For the study, cases (n = 71) were female patients who had documented greater than second-degree perineal injury. The control group (n = 238) was randomly chosen from women who had vaginal delivery but with less or equal to a second-degree perineal laceration. For each patient, we reviewed medical and obstetrics records for the following characteristics: age of diagnosis, gestational age, parity, labor induction, second-stage labor duration, mode of delivery, infant birth weight, epidural use and episiotomy indication, healthcare worker (HCW) experience, and APGAR (appearance, pulse, grimace, activity, and respiration) score.Results: From the 5000 births analyzed, the cases were 71 patients (1.42% of 5000 births). The mean age at diagnosis in our sample was (28.05 ± 4.66 years). The study's results showed that the following variables significantly affected the occurrence of EPTs: birth weight, labor durations, parity, HCW experience, and mode of delivery. The odds for tears were 3.69 (95% CI: 0.156-0.469) higher in nulliparous patients relative to multiparous patients. Instrumental deliveries resulted in more tears than non-instrumental deliveries with an odds ratio (OR) of 5.901 (95% CI: 2. 443-14.525). This study also found that prolonged second-stage labor seems to be associated with an increased risk of perineal damage. HCW experience was looked at in relation to the increased incidence of EPTs, which showed that midwives had a lower incidence rate than physicians with an OR of 2.25 (95% CI: 1.169-4.366). Epidural usage has also been significantly associated with a lesser incidence of perineal tears, which indicates that using epidural could protect against the occurrence of EPTs. Conclusion:In conclusion, the occurrence of perineal lacerations could be prevented during childbirth by taking preventative measures and having more precise judgments. Epidural was a protective factor in our study against the incidence of ext...

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“…Based on the results of our own research, it was found that one of the risk factors for an episiotomy is the first labor. Soleimanzadeh et al (2020) found that 90% of Iranian women who had experienced an episiotomy had their first delivery, while for women who did not have an episiotomy, only 4% [ 22 ]. The results of the research by Beyene et al (2020), Rasouli et al (2016), and Aguiar B. et al (2020) also confirm a significant relationship between the first delivery and more frequent performance of episiotomy [ 8 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the episiotomy was significantly more often performed in the group of younger women that were giving birth and city residents. Soleimanzadeh et al (2020) proved that the mean age of mothers who had an episiotomy was significantly lower than that of mothers without an episiotomy [ 22 ]. Aguiar B. et al (2020) came to the same conclusion [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rasouli et al (2016) made similar observations and found a significant correlation between the episiotomy and a lower Apgar score in the first minute of life and a larger head circumference of the newborn [ 23 ]. Soleimanzadeh et al (2020) noticed that in the group of women who underwent an episiotomy, the newborn’s score according to the Apgar scale in the first and the fifth minutes of life was significantly lower [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Episiotomy for Medical Indications during Vaginal Birth—Retrospective Analysis of Risk Factors Determining the Performance of This Procedure

Bączek

Rychlewicz²,

Sys

et al. 2022

JCM

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The WHO (World Health Organization) recommends that the percentage of perineal incisions should not exceed 10%, indicating that this is a good goal to achieve, despite the fact that it is still a frequently used medical intervention in Poland. The risk factors for perineal incision that have been analyzed so far in the literature allow, among others, to limit the frequency of performing this procedure. Are they still valid? Have there been new risk factors that we should take into account? We have conducted this study to find the risk factors for performing perineal incision that would reduce the frequency of this procedure. The aim of the study was to check whether the risk factors that were analyzed in the literature are still valid, to find new risk factors for perineal incisions and to compare them among Polish women. This was a single-center retrospective case-control study. The electronic patient records of Saint Sophia’s Hospital in Warsaw, Poland, a tertiary hospital was used to create an anonymous retrospective database of all deliveries from 2015 to 2020. The study included the analysis of two groups, the study group of patients who had had an episiotomy, and the control group-patients without an episiotomy in cases where an episiotomy was indicated. A logistic regression model was developed to assess the risk factors for perineal laceration. Independent risk factors for episiotomy in labor include oxytocin use in the second stage of labor (OR (Odds Ratio) = 6.00; 95% CI (Confidence Interval): 4.76–7.58), the supply of oxytocin in the first and the second stage of labor (OR = 3.18; 95% CI: 2.90–3.49), oxytocin use in the first stage of labor (OR = 2.72; 95% CI: 2.52–3.51), state after cesarean section (OR = 2.97; 95% CI: 2.52–3.51), epidural anesthesia use (OR = 1.77; 95% CI: 1.62–1.93), male gender (OR = 1.10; 95% CI: 1.02–1.19), and prolonged second stage of labor (OR = 1.01; 95% CI: 1.01–1.01). A protective factor against the use of an episiotomy was delivery in the Birth Centre (OR = 0.43; 95% CI: 0.37–0.51) and mulitpara (OR = 0.31; 95% CI: 0.27–0.35). To reduce the frequency of an episiotomy, it is necessary consider the risk factors of performing this procedure in everyday practice, e.g., limiting the use of oxytocin or promoting alternative places of delivery.

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Episiotomy and Its Complications

Cited by 5 publications

References 13 publications

The Episiotomy Effect of Topical Combination of Cinnamon Oil and Red Betel on Skin Wound Healing Mechanism

The Episiotomy Effect of Topical Combination of Cinnamon Oil and Red Betel on Skin Wound Healing Mechanism

Retrospective Case-Control Study of Extended Birth Perineal Tears and Risk Factors

Episiotomy for Medical Indications during Vaginal Birth—Retrospective Analysis of Risk Factors Determining the Performance of This Procedure

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