Relationship between primiparity and episiotomy in patients attended to in a high-risk maternity ward of the North Region of Brazil
DOI:
https://doi.org/10.4322/prmj.2020.003Keywords:
episiotomy, perineum, pregnancy, obstetric deliveryAbstract
Purpose: This study aims to evaluate the relationship between primiparity and episiotomy during labor, and the correlation between episiotomy in primiparous women and the occurrence of severe perineal trauma (3rd to 4th degree), in patients attended to in a high-risk maternity ward of the North Region of Brazil, from January 2018 to January 2019. Methods: Crosssectional, descriptive, observational study, where 376 medical records from patients ranging from 15 to 35 years of age and fetal weight upon delivery ranging from 2000 and 3999 grams, who had a vaginal delivery at the institution, were randomly selected and analyzed through variables such as parity, execution of episiotomy and degree of perineal trauma. The Relative Risk (RR) was assessed for the execution of episiotomy among patients and for the development of perineal trauma, with and without episiotomy, among primiparous patients. Results: Out of 282 primiparous patients, 81 (28,73%) were submitted to episiotomy, in comparison with only 4 (4,25%) out of 94 multiparous women. Among primiparous women who underwent episiotomy (81), none developed severe perineal lacerations, and among those who did not undergo the procedure (201), only 3 (1,46%) developed severe perineal lacerations. Conclusion: It was found that primiparity is a risk factor for the execution of episiotomy, and that the procedure does not have statistical relevance in the prevention of severe perineal trauma in primiparous women. The impact of the results will help to reflect upon how the primiparous patient is treated, and will allow the improvement of the maternal assistance, establishing goals to dimish episiotomy rates.
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