Puerperal complications of episiotomies at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

OBJECTIVES: To establish the epidemiological variables associated with episiotomies and their puerperal complications at Ahmadu Bello University Teaching Hospital Zaria, in order to institute appropriate management including preventive measures. DESIGN: A prospective cohort study. SETTING: Ahmadu cello University Teaching Hospital, Zaria, Nigeria. METHODS: A cohort of all consecutive patients that underwent vaginal deliveries during a 12-week period were followed up for six weeks in order to determine the distribution and determinants of episiotomy and its complications. RESULTS: The episiotomy rate was 35.6% of all vaginal deliveries. Episiotomies were significantly associated with primigravidity being performed in 88.5% of all primigravidae. The mean delivery-repair interval was 60.5 minutes. The most common puerperal complication of episiotomies was perineal pain that lasted an average of 5.5 days. Other complications included asymmetry (32.9%), infection (23.7%), partial dehiscence (14.5%), skin tags (7.9%), haemorrhage (5.3%) and extension of the incision (1.3%). The complications were not significantly associated with any potential risk factor. CONCLUSION: In view of the very high episiotomy rate among primigravidae, it is recommended that the episiotomy rate among primigravidae be reduced by re-acquainting accoucheurs with the indications for episiotomy. Attention needs to be given to adequate pain relief for all women who have had an episiotomy and the delivery-repair interval in this unit should be reduced by provision of materials for episiotomy repair in the delivery suite.