Case control study of episiotomy in the University Teaching Hospital (CHU) Yaounde

Abstract

The aim of the study was to determine the incidence and identify the factors influencing the practice of episiotomy during delivery in the University Teaching Hospital, Yaounde. It is a retrospective review of all vaginal deliveries conducted in this hospital between January 2001 and December 2002 was undertaken to identify all cases of episiotomy. To each case we identified a control who was the first parturient to have vaginal birth after the case of episiotomy. Multivariable logistic regression models were used to generate odd ratios after adjustment for multiple confounders. The overall incidence of episiotomy among the 3411 paturients who had vaginal births during the period was 13.3%. The incidence of spontaneous perineal tears was 18.3%. Up to 68.4% of paturients had intact perineum. The major independent risk factors were nulliparity (odd ratio [OR] = 2.710, 95% confidence interval [CI] 1.76-4.18), age below 25 years (OR = 1.554, CI 1.12-2.15), delivery by an obstetrician (OR = 3.095, CI 1.59-6.03) or a resident (OR = 2.748, CI 1.95-3.88), forceps delivery (OR = 16.312, CI 2.01-132.11), ventouse delivery (OR = 5.055, CI 1.87-13.71). The Apgar score was not significantly different between the cases and controls in the 5th minute. We conclude that the incidence of episiotomy in this hospital is quite low in conformity with current recommendations. The risk factors include instrumental delivery, cadre of the provider, nulliparity and young age (< 25 years) of the parturient. .

Clinics in Mother and Child Health Vol. 1(2) 2004: 97-102