ASSESSMENT OF IMMEDIATE PERINEAL COMPLICATIONS OF NORMAL VAGINAL DELIVERY VERSUS VAGINAL DELIVERY WITH EPISIOTOMY IN TERM PREGNANCY IN A TERTIARY CARE HOSPITAL

Objectives: To assess immediate intra and postpartum perineal complications following normal vaginal delivery versus vaginal delivery with episiotomy in term pregnancy. Material and methods: This Cross-sectional study, was conducted in Peshawar, Lady Reading Hospital, Gynae ward from 1st November 2019 to 31st January 2020 after approval from Institutional Research Board. A total of 250 patients (125 in each group), 120 in group A with normal vaginal delivery, 115 in group B (vaginal delivery with an episiotomy), and 15 patients were excluded due to different modes of delivery (instrumental delivery/cesarean section). All patients with full-term pregnancies were included. Patients who refused to give consent or had bleeding disorders and indications for instrumental delivery or cesarean section were excluded. Non-probable convenience sampling technique, P-value <0.05, 95% confidence interval, and Chi-square test used for statistical analysis Results: In the group, A mean age of 22 years, primigravida (PG) 84 (70%) multigravida (MG) 36 (30%) mean period of gestation (POG) 38 weeks, 96(80%) spontaneous, 24 (20%) induced labor. In group B the mean age was 21.8 years, PG 77 (66%), MG 38(33%), mean POG 41 weeks, 97 (84%) spontaneous, and 18 (15%) induced labor. Group A vaginal tears 6 (5%), cervical tears 4 (3%), mixed tears 9 (7.5%), para-urethral tears 2 (1.6%), and perineal tears 9(7.5%). Group B vaginal tears 3 (2.6%), cervical tears 3 (2.6%), mixed tears 2 (1.7%). No significant post-natal pain difference was observed in the groups. CONCLUSION:  Routine practice of episiotomy should be discouraged as no significant difference was observed in both groups. KEYWORDS: Episiotomy, Term pregnancy, Vaginal delivery.