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.