Comparison of Routine Versus Restrictive Episiotomy in Primigravida Women at Term.

Comparison of Outcome in Terms of Perineal Tear and Postpartum Hemorrhage (PPH) in Routine Versus Restrictive Episiotomy in Primigravida Women at Term.

The ongoing debate over routine versus selective episiotomy in primiparous term women underscores the necessity for updated local data. Consequently, this study was designed to compare the outcomes-specifically regarding perineal tears and postpartum hemorrhage (PPH)-between routine and selective episiotomy in primigravida women at term.

Perineal tears remain a common concern following normal vaginal delivery, particularly among primigravida women delivering at term. Episiotomy has traditionally been performed to reduce the risk or severity of perineal trauma, although the benefits of routine versus selective episiotomy remain a subject of ongoing debate. While routine episiotomy may be considered protective in some circumstances, restrictive use has also been advocated to avoid unnecessary perineal injury and other associated complications. This study aims to provide baseline data on perineal tears among primigravida women undergoing normal vaginal delivery, thereby promoting greater vigilance during labor and delivery. The findings may also help obstetricians make informed decisions regarding the appropriate use and justification of episiotomy in this population.

Inclusion Criteria:

• Primigravida
• Aged18 - 40 years
• Gestational age of ≥ 37 weeks
• Admitted to the labor room (either spontaneous or induced labor) for episiotomy

Exclusion Criteria:

• Abnormal and cephalic presentations with occipitoposterior position
• Instrumental delivery (vacuum or forceps)
• Pre - eclampsia / Eclampsia
• Gestational diabetes mellitus
• Fetal abnormality
• Intrauterine growth restriction
• History of pelvic surgery or neuromuscular diseases
• Twin pregnancies
• Fetal macrosomia