Episiotomy in Nigeria

Objective: To review the incidence and complications associated with episio tomy and perineal tears at the University of Benin Teaching Hospital, Benin City, Nigeria. Method: A retrospective review of all vaginal births conduc ted in the hospital between January 1997 and December 1998 was undertaken. Vaginal births (1345) were reviewed. Result: The prevalence of episiotomy i n the hospital during the period was 46.6%. Over 90% of primigravid parturi ents had episiotomy. The incidence of episiotomy decreased with increasing parity, while the incidence of spontaneous vaginal tears increased with par ity. As compared with perineal tears, episiotomy was associated with a stat istically significant increased risk of wound breakdowns requiring secondar y resuturing. When controlled for parity, breech births, forceps and vacuum delivery were more likely to lead to episiotomy, compared to spontaneous v ertex delivery occurring at term. Conclusion: A policy of systematic reduct ion in the incidence of episiotomy can be pursued in this hospital. Greater attention needs to be paid to selection of women to undergo episiotomy, th e prevention of spontaneous perineal tears and the care of episiotomy wound s in this institution. (C) 2000 International Federation of Gynecology and Obstetrics.