Episiotomy in Nigeria

Abstract

OBJECTIVE: To review the incidence and complications associated with episiotomy and perineal tears at the University of Benin Teaching Hospital, Benin City, Nigeria. METHOD: A retrospective review of all vaginal births conducted in the hospital between January 1997 and December 1998 was undertaken. Vaginal births (1345) were reviewed. RESULT: The prevalence of episiotomy in the hospital during the period was 46.6%. Over 90% of primigravid parturients had episiotomy. The incidence of episiotomy decreased with increasing parity, while the incidence of spontaneous vaginal tears increased with parity. As compared with perineal tears, episiotomy was associated with a statistically significant increased risk of wound breakdowns requiring secondary resuturing. When controlled for parity, breech births, forceps and vacuum delivery were more likely to lead to episiotomy, compared to spontaneous vertex delivery occurring at term. CONCLUSION: A policy of systematic reduction in the incidence of episiotomy can be pursued in this hospital. Greater attention needs to be paid to selection of women to undergo episiotomy, the prevention of spontaneous perineal tears and the care of episiotomy wounds in this institution.