Episiotomy and Perineal Tears in Primigravidae

The objective of the study was to determine the frequency and indications for episiotomy and perineal tears in primigravidae. Design: Descriptive. Patients and methods: Retrospective data analysis of all the primigravidae delivered in gynae unit III, Jinnah Hospital Lahore from September 2009 to February 2010. The data consisted of age, period of gestation, type of delivery spontaneous with or without episiotomy or assisted with forceps or vacuum, duration of second stage of labour and reason for making episiotomy. Perineal tears if present were recorded for site, size, involvement of skin, muscle and mucosa. Results: A total of 621 primigravidae delivered during the study period. Out of these 444 delivered vaginally. Out of these 61.67% delivered with episiotomy, 6.60% delivered vaginally without episiotomy and 2.25% delivered with vacuum and forceps. 1.44% of the patients had perineal tears or lacerations. 0.9% of the tears occurred in the vaginal delivery with episiotomy, 0.16 in vaginal delivery and 0.3% in vaginal delivery with vacuum and forceps. The indications for making an episiotomy was impending tear in 42.56% and prolonged second stage of labour in 42.82% of the cases. Conclusion: This study concludes that frequency of perineal tears is low in low risk primigravidae delivering in tertiary care hospital with or without episiotomy. The frequency of performing episiotomy in low risk primigravidae is high with indications being impending tear and prolonged second stage of labour.