Evaluation of Perineal Trauma in Primiparous Women with Routine and Selective Episiotomy

Document Type : Original Article


1 Lecturer of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. Student of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Lecturer, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Specialist in Obstetrics and Gynecology, Kamali Hospital, Karaj, Iran.


Introduction: Perineal lacerations are common perineal injuries in primiparous women and episiotomy is the most common surgical incision in obstetrics. There is no reliable evidence for confirming the routine use of episiotomy and it is recommended to perform selective episiotomy for fetal and maternal indications. This study was performed in order to compare perineal trauma in primiparous women with routine and selective episiotomy in Modarres Hospital of Kashmar.
Methods: This clinical randomized trial was performed on 100 primiparous women aged between 17-35 years with spontaneous delivery in Modarres hospital of Kashmar in year 2003. Cases were selected by aims of study and were randomly divided into two groups of routine and selective episiotomy. All deliveries were done by researcher but evaluation of perineal outcome after delivery was done by another researcher who did not know about types of groups. Data were obtained from interviewing, observation forms and measurement of pelvic muscle strength and analyzed with student t-test, chi-square, and Mann Whitney and Fisher test by SPSS 11.5 software.
Results: 12(24%) of women in selective group and 50(100%) in routine group had episiotomy (p<0/0001). Perineal injury happened in 62% of selected group and 100% of routine group, which was statistically different (p<0/0001). The two groups were similar in terms of variables effective on perineal trauma.
Conclusion: Selective episiotomy can reduce perineal injuries; therefore, it can be replaced routine episiotomy as a safe and time saving method.


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