Third and Fourth Degree Perineal Lacerations of Episiotomy Versus Non-Episiotomy in Spontaneous Vaginal Deliveries at Phramongkutklao Hospital

Abstract

Objective To study third and fourth degree perineal lacerations of episiotomy versus nonepisiotomy in spontaneous vaginal deliveries.
Materials and Methods 164 term singleton pregnancies admitted for spontaneous vaginal
deliveries were randomly assigned to episiotomy or non-episiotomy at the time of deliveries.
The primary outcome was number of third and fourth degree perineal lacerations.
Postpartum perineal pain score was also assessed at 24 and 48 hours in different positions
(stand, walk, lie down and sit).
Results 164 term singleton pregnancies were analyzed (82 cases / group). None of fourth
degree laceration was found in this study. Third degree laceration occurred 8.5% in
episiotomy group and 1.2% in non-episiotomy group (Relative risk, 8; 95% confidence
interval [CI] 1.28 to 50.04). No difference in perineal pain score at 24 and 48 hours
postpartum.
Conclusion In term pregnancies with spontaneous vaginal deliveries, the episiotomy group had
more risk of third degree perineal laceration than non-episiotomy group with no difference in
pain.