Comparison of Perineal Tears in Primigravida during Vaginal delivery at Term with and without Medio -Lateral Episiotomy

Abstract

Background: Perineal tear clinically defined as tearing the perineal skin and muscles only. Sometimes injury involving the anal sphincter or anal mucosa results in major degree tears, causing faecal urgency or incontinence. Prophylactic episiotomy is performed to prevent the laceration of skin and soft tissue of perineum and involvement of anal canal and rectum is still controversial. Clinically perineal tissue stretching is done by perineal massage in antenatal period or during second stage of labor.

 OBJECTIVES: To compare the frequency of major degree perineal tears with and without Medio Lateral Episiotomy in primigravida during  spontaneous vaginal delivery at term.

Material and Methods: This present randomized control trial was carried out at gynae unit 5, KEMU, Lady Aitchison hospital, Lahore in a period of one year.(1-7-2015 to 30-6-2016) The non-probability, purposive sampling technique was used to randomized the study population. Informed consent and demographic information was obtained. The data was entered and analyzed on SPSS version 17.

 Results: In our study the mean age of the patients was 28.43±6.33 years and the mean gestational age was 39.46±1.14 weeks. The perineal tear were present in 29(16.11%) patients, The first degree perineal tear was present in 8(27.59%) cases. The second, third and fourth degree of perineal tears was present in 7(24.14%) patients each respectively.

Conclusion: According to our study the incidence of perineal tear was 29(16.11%). No significant association was found between groups and degree of perineal tear.