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PUERPERAL COMPLICATIONS OF EPISIOTOMIES AT AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA, NIGERIA
Abstract
ABSTRACT
Objectives: To establish the epidemiological variables associated with episiotomies and their
puerperal complications at Ahmadu Bello University Teaching Hospital Zaria, in order to
institute appropriate management including preventive measures.
Design: A prospective cohort study.
Setting: Ahmadu cello University Teaching Hospital, Zaria, Nigeria.
Methods: A cohort of all consecutive patients that underwent vaginal deliveries during a 12-
week period were followed up for six weeks in order to determine the distribution and
determinants of episiotomy and its complications.
Results: The episiotomy rate was 35.6%of all vaginal deliveries. Episiotomies were significantly
associated with primigravidity being performed in 88.5% of all primigravidae. The mean
delivery-repair interval was 60.5 minutes. The most common puerperal complication of
episiotomies was perineal pain that lasted an average of 5.5 days. Other complications
included asymmetry (32.9%), infection (23.7%), partial dehiscence (14.5%), skin tags
(7.9%), haemorrhage (5.3%) and extension of the incision (1.3%). The complications were
not significantly associated with any potential risk factor.
Conclusion: In view of the very high episiotomy rate among primigravidae, it is recommended
that the episiotomy rate among primigravidae be reduced by re-acquainting accoucheurs
with the indications for episiotomy. Attention needs to be given to adequate pain relief for all
women who have had an episiotomy and the delivery-repair interval in this unit should be
reduced by provision of materials for episiotomy repair in the delivery suite.
Objectives: To establish the epidemiological variables associated with episiotomies and their
puerperal complications at Ahmadu Bello University Teaching Hospital Zaria, in order to
institute appropriate management including preventive measures.
Design: A prospective cohort study.
Setting: Ahmadu cello University Teaching Hospital, Zaria, Nigeria.
Methods: A cohort of all consecutive patients that underwent vaginal deliveries during a 12-
week period were followed up for six weeks in order to determine the distribution and
determinants of episiotomy and its complications.
Results: The episiotomy rate was 35.6%of all vaginal deliveries. Episiotomies were significantly
associated with primigravidity being performed in 88.5% of all primigravidae. The mean
delivery-repair interval was 60.5 minutes. The most common puerperal complication of
episiotomies was perineal pain that lasted an average of 5.5 days. Other complications
included asymmetry (32.9%), infection (23.7%), partial dehiscence (14.5%), skin tags
(7.9%), haemorrhage (5.3%) and extension of the incision (1.3%). The complications were
not significantly associated with any potential risk factor.
Conclusion: In view of the very high episiotomy rate among primigravidae, it is recommended
that the episiotomy rate among primigravidae be reduced by re-acquainting accoucheurs
with the indications for episiotomy. Attention needs to be given to adequate pain relief for all
women who have had an episiotomy and the delivery-repair interval in this unit should be
reduced by provision of materials for episiotomy repair in the delivery suite.
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