Effect of episiotomy on perineal laceration in primparous women referring to Shabihkhani maternity hospital, Kashan city, Iran

Considering the application of episiotomy technique for all the primiparous patients referring to Shabihkhani maternity hospital at Kashan city and the complications of this technique (e.g. hematoma, third and fourth degree laceration), this study was carried out to compare the extent of perineal laceration in primparous women in the absence or presence of this technique during 2005-6. This clinical trial study was carried out on two groups of term primiparous women (No=180) with a cephalic fetal presentation and an estimated fetal weight of 2500-3500 g. The length of posterior or anterior perineal laceration and the lacerations requiring repair were compared in both groups using T, Exact Fisher and X2 statistic tests. In addition, multiple logistic regression analysis was used to express simultaneity factor effects. In case group 44.4% of the deliveries were without laceration and 55.6% with a posterior perineal laceration (P<0.001). The mean length of posterior perineal laceration in case and control group was 2.15±2.47 cm and 6.98±1.51 cm, respectively (P<0.001). The mean score for second-degree laceration length in case and control group was 6.64±0.89 cm and 7.00±1.52 cm, respectively (P=0.18). In case group, 14 (7.8%) out of 22 (12.2%) cases of anterior laceration needed to be repaired (P<0.001). Delivery in the absence of episiotomy can lead to a reduction in the frequency of perineal laceration; the length of laceration in case group was smaller than that in the control group.