Factors associated with episiotomy among parturients delivering in a tertiary care centre in Nigeria

Owa, Olorunfemi Oludele; Eniowo, Akinbowale Romance; Ilesanmi, Olayinka Stephen

doi:10.5455/2320-6012.ijrms20150403

Cited by 10 publications

(20 citation statements)

References 16 publications

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“…19 Similar to present finding, birth weight was not a significant factor for episiotomy this could be because most macrosomic babies were delivery by women who were multiparous. 20 The present study shows proportion of delivery during 4 PM-8 PM 16% is similar 17% to study conducted at Harare Maternity Hospital, Harare, Zimbabwe. 21 However higher 41.6%, 34% and 27.3% is observed in the present study during time period 8 AM-4 PM, 8 PM -12 AM and 12 AM-8 AM compared to 31%, 15.2% and 18% in the other study…”

Section: Mother Characteristics and Newborn Outcomesupporting

confidence: 86%

A study on obstetric care in a primary health center of South Assam district, India

Dey¹,

Chutia²

2018

Int J Community Med Public Health

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Background: Maternal and child health are critically important in a country that is experiencing high infant mortality and maternal mortality. Research all over the world has suggested that one of the major solutions to this problem is availability of Emergency Obstetric Care services within the reach of people. Objectives of the study were to examine profile of mothers who have delivered in health facility during a year and the interplay of various factors in child birth and newborn outcome.Methods: Retrospective cross sectional study conducted by collecting information in predesigned format from medical records. Appropriate statistical methods and test of significance performed for qualitative and quantitative variables.Results: Out of 539 women, the majority of 42.9% were in the age group 20-25 years, the mean age (SD) of mother was 24.1 years (±4.09). Out of total 539 vaginal deliveries, 56.6% cases episiotomy was performed. 41.6% deliveries occurred from 8 AM to 4 PM. The mean birth weight was 2.830 kg SD 0.439 and low birth prevalence 16.0%. Parity with time to delivery after admission in different age groups revealed significant association (X2=66.456, p=0.000). Women aged less than 20 years are 12 times more at risk of episiotomy performed. The multivariate logistic regression analysis shows 60.67% specificity and 85.59% sensitivity in predicting episiotomy.Conclusions: From study it is evident that women report to hospital late in labor hence there is urgent need to provide quality antenatal care services at village and PHC level and augment awareness among the community for promotion of safe motherhood.

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Section: Mother Characteristics and Newborn Outcomesupporting

confidence: 86%

A study on obstetric care in a primary health center of South Assam district, India

Dey¹,

Chutia²

2018

Int J Community Med Public Health

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“…Whereas, this finding was almost two to three times higher than the study conducted in the Democratic Republic of Congo 20.4%, 40 Brazil 29.1%, 41 Vietnam 29.9%, 42 Burkina Faso 22%, 43 and Nigeria 9.3%. 44 The reason for this might be that in those countries the practice of routine episiotomy was restricted by national guidelines and they were valuing recommendations from WHO. Nevertheless, some studies that have a higher prevalence of episiotomy practice than the result of this study; Saudi Arabia 51.20%, 45 Oman 66.0%, 46 India 63.4%, 47 Turkey 52.0%, 48 Romania 92.7%, 49 Colombia 94.5%, 50 and Uganda 73%.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of episiotomy practice and factors associated with it in Ethiopia, systematic review and meta-analysis

Figa

Chekole

Bedada

et al. 2022

Womens Health (Lond Engl)

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An episiotomy is one of the most commonly performed obstetrics surgeries indicated in emergencies during the second stage of labor like fetal distress, dystocia, and tight perineum. As a result, this systematic review and meta-analysis aimed to assess the prevalence of episiotomy practice and associated factors in Ethiopia. Ten cross-sectional studies with a total population of 3718 were included in this study. The search was done using online databases like PubMed, HINARI, Web of Science, other gray, and online repositories of Universities. All the included papers were extracted and appraised using the standard extraction sheet format of JOANNA Briggs Institute. The Cochran Q-test and I2 statistics test were used to test the heterogeneity of studies. To detect the publication bias of the included studies, a funnel plot and Egger’s test were used. The pooled prevalence of episiotomy practice and the odds ratio with a 95% confidence interval were presented using forest plots. The overall pooled prevalence of episiotomy practice was 45.11% (95% CI; 37.04–53.18; I2 = 96.3%). Prolonged second stage of labor (OR: 4.79, 95% CI: 3.03, 7.57), face presentation (OR: 4.26, 95% CI: 1.21, 15.07), birth weight > 4000 g (OR: 6.71, 95% CI: 3.14–14.33), instrumental delivery (OR: 4.26, 95% CI 2.95, 6.14), and primiparity (OR: 3.70, 95% CI: 1.90, 7.2) were factors associated with episiotomy practice. The overall prevalence of episiotomy practice was higher in Ethiopia compared to studies conducted in other countries. The prolonged second stage of labor, face presentation, birth weight > 4000 g, instrumental delivery, and primiparity of women were the factors associated with episiotomy practice. Therefore, efforts should be made to prevent routine episiotomy practice through creating awareness, adjusting national guidelines, affecting the World Health Organization episiotomy policy, and monitoring the activities of the health care facilities in executing the protocols.

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“… 7 The episiotomy rate of 35.2% has been reported in Ethiopia. 8 The episiotomy rates reported in various centers in Nigeria was 9.3% at the Federal Medical center Owo, 9 20.8% at Jos University Teaching Hospital, 10 34.3% at the Bowen University Ogbomosho, 11 35.4% at the Ahmadu Bello University Teaching Hospital Zaria, 1 40.1% at the University of Port Harcourt, 12 45% at the Abia State University Teaching Hospital, 13 and 54.9% at the University of Benin Teaching Hospital. 14 Although the use of episiotomy is common in the practice of obstetrics in Nigeria; many of our women have very minimal knowledge of it; while the majority have a strong aversion to it.…”

Section: Introductionmentioning

confidence: 98%

“… 32 Most of the complications resulting from episiotomies are usually not life-threatening and are often neglected in obstetrics practice in Nigeria. However, it must be emphasized that ill health resulting from immediate postepisiotomy complications constitutes a serious cause of maternal morbidity, particularly in the puerperium, 1 2 9 whereas late complications such as coital difficulties, dyspareunia, and gaping introitus occasioned by faulty repair will adversely affect the couple's sexual and reproductive lives. 32 These complications need attention.…”

Section: Introductionmentioning

confidence: 99%

Review of episiotomy and the effect of its risk factors on postepisiotomy complications at the University of Port Harcourt Teaching Hospital

et al. 2020

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Aim: This study aimed to determine the prevalence of episiotomy and postepisiotomy complications and to assess the relationship between the risk factors and postepisiotomy complications in the University of Port Harcourt Teaching Hospital. Methodology: This was a descriptive longitudinal study, in which 403 consecutive women who had episiotomy in the labor ward were recruited for the study. They were followed up and reviewed at the postnatal clinic on the 1 st and 6 th weeks postdelivery. Data regarding age, marital status, occupation, educational status, address, parity, booking status, postepisiotomy complications, and the associated risk factors were entered adequately into a prestructured pro forma, and statistical analysis was done using statistical software (SPSS for Windows ® version 19.0). t-test was used to explore the association of risk factors to postepisiotomy complications. Results: The episiotomy rate was 22.1%. The prevalence of postepisiotomy complications was 52.1%. The mean age of the women was 23.8 (standard deviation ± 3.2) years. Seventy-two (34.3%) patients had perineal pain, which lasted for 72 h or more; 61 (29.1%) had difficulty in walking, while 37 (17.6%) had perineal discomfort. Four (1.9%) had wound infection and only one (0.4%) had wound dehiscence. The development of postepisiotomy complications was not statistically significantly associated with risk factors such as gestational age ( T = 1.4, P = 0.1), packed cell volume on admission ( T = 1.0, P = 0.2), duration of first stage of labor ( T = 0.5, P = 0.1), duration of second stage of labor ( T = 0.7, P = 0.3), duration of rupture of fetal membranes ( T = 0.8, P = 0.4), delivery repair interval ( T = 0.6, P = 0.2), estimated blood loss ( T = 0.9, P = 0.2), duration of Sitz bath ( T = 1.0, P = 0.2), duration of analgesic ( T = 1.2, P = 0.1), duration of antibiotics ( T = 1.3, P = 0.1), or the operator who performed or repaired the episiotomy ( P = 0.2). Conclusion: The prevalence of episiotomy and postepisiotomy complications in this study was high. Necessary attention should be given to ensure adequate pain relief for all parturients who had episiotomy, and the policy of restrictive use of episiotomy should be fully implemented in the department in line with the best practices and evidence-ba...

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Factors associated with episiotomy among parturients delivering in a tertiary care centre in Nigeria

Cited by 10 publications

References 16 publications

A study on obstetric care in a primary health center of South Assam district, India

A study on obstetric care in a primary health center of South Assam district, India

Prevalence of episiotomy practice and factors associated with it in Ethiopia, systematic review and meta-analysis

Review of episiotomy and the effect of its risk factors on postepisiotomy complications at the University of Port Harcourt Teaching Hospital

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