Risk factors for Episiotomy Wound Infection of Parturients Delivered, Nopparatrajathanee Hospital


  • Kiennukul N, Khuanped S, Tonkulrat W, Aiumlaor P


Risk factor, Episiotomy wound infection


This study was a retrospective case control design. The aim of this study was to investigate general information and risk factors for episiotomy wound Infection of parturients delivered in Nopparatrajathanee hospital. Data were collected from the medical records of Nopparatrajathanee hospital between October 1, 2014 and September 20, 2017. The subjects were 188 women. They were divided into two groups; 39 in a case group and 149 in a control group. Data were analyzed using Stata statistical software version 14. Descriptive statistics were performed to describe frequency, percentage, mean and standard deviation. Univariable Odds Ratio Regression and Multivariable Odds Ratio Regression reduced model were employed risk factors for episiotomy wound infection. Results showed that 39 (27%) women had episiotomy wound infection and 149 (79.3%) women were without episiotomy wound infection. The majority of participants were teenagers (79.8%; 150/188) and their education levels were primary school or lower (48.4%; 91/188). The majority of women with episiotomy wound infection group (61.5%; 24/39) were foreign nationals (Laos, Cambodia and Myanmar) and most of them (38.5%; 15/39) were Myanmar. The majority of women with normal perineum (66.4%; 99/149) were Thai people. Risk factors for episiotomy wound infection were 16.5 times greater in women with episiotomy (OR = 16.5, 95% CI = 2.2-125.8; p-value <0.001) and 3.4 times greater in foreign women (Laos, Cambodian and Myanmar) (OR = 3.4, 95% CI = 1.58-7.22; p-value = 0.001). In conclusion, episiotomy during vaginal birth and nationalities were risk factors for episiotomy wound infection of the deliveries in Nopparatrajathanee Hospital.


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Chotnopparatpattara P. Obstetrics complications.In: Charoenvidhya D, editors. Obstetrics Department of Obstetrics and Gynaecology. 3rd ed. Bangkok: O.S. Printing House; 2005. p. 434-41.

Hatkaew N, Theerasopon P. The Effect of Cold Polymer Gel Pack Compression on Postpartum Perineal Pain. Journal of Phrapokklao Nursing College 2015; 26:1-5.

Charoenpanich P. Parturition physiology and problems. 1st ed. Bangkok: 21 Century; 1997.

Christianson LM, Bovbjerg VE, McDavitt EC, Hullfish KL. Risk factors for perineal injury during delivery. Am J Obstet Gynecol 2003; 189:255-60.

Hudelist G, Gelle’n J, Singer C, Ruecklinger E, Czerwenka K, Kandolf O, et al. Factors predicting severe perineal trauma during childbirth: role of forceps delivery routinely combined with mediolateral episiotomy. Am J Obstet Gynecol 2005; 192:875-81.

Khamching C. Obstetric Perineal Laceration. 2015 [updated 2015 Mar 19; cited 2017 Mar 30]; Available from: http:// www.med.cmu.ac.th/dept/obgyn/2011/index.php? option=com_content&view=article&id=1103:obstetricperineal- laceration&catid=45&Itemid=561.

Fitzpatrick M, O’Herlihy C. Postpartum care of the perineum. The Obstetrician & Gynaecologist 2007; 9:164-70.

Braga Giordana Campos CSTP, Luz Patrícia Ferreira Neves da, Scavuzzi Adriana, Noronha Neto Carlos, Amorim Melania Maria Ramos,. Risk factors for episiotomy: a case-control study. 2014 [2017 Apr 10]; 465-72]. Available from: http:// www.scielo.br/scielo.php?script=sci_arttext&pid =S0104-42302014000500465&lng=en. http://dx.doi.org/ 10.1590/1806-9282.60.05.015.

American College of Obstetricians and Gynecologists. Guideline Summary NGC-5706: Episiotomy. 2013 [2017 Apr 10]; Available from: http://www.guideline.gov/content. aspx?id=10926.

Sitthichaiyakul P. Acute and Chronic Inflammation. 2009 [2017 Mar 31]; Available from: http://www.meded.nu.ac.th/ backoffice/attachments/ACUTE%20AND%20CHRONIC%20 INFLAMMATION.pdf.

Hormnaim N. The Nursing Roles to Promote Wound Healing by Using Nutrition Principles. Journal of The Police Nurse 2014; 6:234-49.

Jenwiteesuk K. Basic Wound Healing and Wound Bed Preparation. การประชุมวิชาการ Srinagarind Medical Journal 2013; 29:10-7.

Oprasertsawat P, Phuapradit N, Taneepanichskul S, editors. Ramathibodi Obstetrics 2. 2nd ed. Bangkok: Holistic publishing; 1997.

Sornprasit K. Nursing for postpartum mothers with complications 1st ed. Songkhla: Tem publishing; 1997

Johnson A, Thakar R, Sultan AH. Obstetric perineal wound infection: is there underreporting? BJN (Mark Allen Publishing) 2012; 21:s28, s30, s2-5.

Macleod M, Strachan B, Bahl R, Howarth L, Goyder K, Van de Venne M, et al. A prospective cohort study of maternal and neonatal morbidity in relation to use of episiotomy at operative vaginal delivery. BJOG 2008; 115:1688-94.

Duggal N, Mercado C, Daniels K, Bujor A, Caughey AB, El-Sayed YY. Antibiotic prophylaxis for prevention of postpartum perineal wound complications: a randomized controlled trial. Obstet Gynecol 2008; 111:1268-73.

Wang Y, Puangsricharern A. Immediate Maternal and Neonatal Outcomes of Forceps and Vacuum-assisted Deliveries at Rajavithi Hospital. Thai J Obstet Gynaecol 2009; 17:80-4.

Angioli R, Gomez-Marin O, Cantuaria G, O’Sullivan M J. Severe perineal lacerations during vaginal delivery: the University of Miami experience. Am J Obstet Gynecol 2000;182:1083-5.

Klankhajhon S. Nursing care for shoulder dystocia. Journal of Nursing and Health Sciences 2013; 7:1-11

Buphasiri P. Shoulder Dystocia. Srinagarind Med J. 2011; 26(1):64-70.

Sangin S. Nursing Care for Mother with Fetal Occiput Posterior Position. BUU Nursing J 2017; 25:1-11.

Noppharat Ratchathani Hospital. Data of the labor and delivery rooms Noppharat Ratchathani Hospital. [ Database] Available from: Noppharat Ratchathani Hospital Information System: 2016.

Noppharat Ratchathani Hospital. Data of the labor and delivery rooms Noppharat Ratchathani Hospital. [Database] Available from: Noppharat Ratchathani Hospital Information System: 2014-2016.

Bernard R. Fundamentals of biostatistics. 5thed. Duxbery: Thomson learning; 2000.p.384-385.

CDC/NHSN Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting 2013 [2017 March 10]; Available from: http://www.socinorte.com/ wp-content/uploads/2013/03/Criterios-de-IN-2013.pdf

Sussman C, Cuddigan J, Ayello E, Lyder C, Langemo DK. Measuring Pressure Ulcer Healing is Critical to Quality of Life. Paper presented at: Partnership for Health in the New Millenium: Launching Healthy People 2010, Washington, DC, 2000.

Kittipongpattana S, Ploipai S, Leesmidt V. Predictive Factors of the Episiotomy Wound Inflammation of the Deliveries Khlongkhlung Hospital Kamphaengphet Province, 2007. Journal of Nursing Science Naresuan University 2008; 2:79-89.

Kovavisarach E, Chairaj S, Tosang K, Asavapiriyanont S, Chotigeat U. Outcome of Teenage pregnancy in Rajavithi hospital. J Med Assoc Thai 2010; 93:1-8.

Oatme S, Kruachottikul S. Guidelines for Midwives in Cross-Cultural Communication with Myanmar Pregnant Women. Princess of Naradhiwas University Journal 2017; 9:150-161.

Wongduan N, Sasiwongsaroj K, Doungphummes, Bhibulbhanuvat S. Intercultural Communication Competence for Health Care Services in Migrant Workers. In: Wimolsiri R, editor. Khon Kaen University Graduate Research Conference 2014. Khon Kaen: Khon Kaen University; 2014. P. 2372-80.

Noppharat Ratchathani Hospital. Medical Statistics report of Noppharat Ratchathani Hospital.[ Database] Available from: Noppharat Ratchathani Hospital Information System: 2017.

Osotsathian S. Postpartum: Nursing diagnosis and nursing care plan. Bangkok: The Office of the University Press Sukhothai Thammathirat Open University; 1998

Schuurmans N, Mackinnon C, Lane C, Etches D. Prevention and management of postpartum haemorrhage. J Soc Obstet Gynaecol Can 2000; 88: 273.

Tittabut J, Kunachon S. Episiotomy case study case service wound dehiscence. [cited July 1, 2018]; Available from: https://dokumen.tips/documents/clinical-research568af8ff2ef99.html.

Dimitrov, A.,Tsenov,D.,and Ganeva,G. Causes for healing complications in episiotomy. Akush Ginekol (Sofiia) 2000; 40:17-20.

Lowenstein L, Drugan A. Episiotomy: Beliefs, practice and the impact of educational intervention. Eur J Obstet Gynecol Reprod Biol 2005; 123:179-182.

Kweankasikan N, Baosoung C, Parisunyakul S. Effect of Perineal Massage on Perineal Trauma in Normal Childbirth. Nursing Journal 2010; 1:96-107.

Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J, & Lohr K N. Outcomes of routine episiotomy: A systematic review. JAMA 2005; 293:2141-148.

Chanwijit T, Chawongluang T. Complication of parturients delivered with or without episiotomy in Krabi Hospital. Journal of the Department of Medical Services 2016; 41:108-112

Supadech C, Buranawit K, Komolpis S, Panichkul S. Third and Fourth degree perineal laceration of episiotomy versus non-episiotomy in spontaneous vaginal deliveries at Pharamongkutklao Hospital. Thai J Obstet Gynecol 2008; 16:199-205.

World Health Organization [WHO]. Care in normal birth: A practical guide. Geneva: World Health Organization, 1996.

ACOG Practice Bulletin. Episiotomy. Clinical Management Guidelines for Obstetrician –Gynecologists. Obstet Gynecol 2006; 107:957-62.

Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database Systematic Reviews 2009, CD000081.doi:10.1002/ 14651858.CD000081. pub2.



How to Cite

นุชนารถ เขียนนุกูล วท.ม., สินจัย เขื่อนเพชร พย.บ., วรรณวรา ตัณฑ์กุลรัตน์ พย.บ., พรนภา เอี่ยมลออ วท.ม. Risk factors for Episiotomy Wound Infection of Parturients Delivered, Nopparatrajathanee Hospital. j dept med ser [Internet]. 2019 Aug. 1 [cited 2022 Aug. 19];44(4):144-51. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/246727



Original Article