The proportion of perineal tear in the selective episiotomy in vaginal birth at Hung Vuong hospital in 2021

Hoang Thi Thuy Trang¹

Background: Vaginal birth can be caused of tears in the vaginal and its surrounding tissues, it usually happens when the baby's head is gone through the vaginal. In some cases the tears can extend to the rectum and take a long time for recovery. To avoid deep lacerations, clinicians had recommended keeping the vaginal before and during giving birth (selective episiotomy) to avoid severe lacerations and facilitate for successful vaginal birth [1].

Objectives: Determine the proportion of the perineal tears; factors and outcomes related to the selective episiotomy in vaginal birth.

Methods: A cross-sectional study was conducted on 367 medical records of post-partum women who were applied the selective episiotomy in vaginal birth at Hung Vuong Hospital from April to June 2021.

Results: The proportion of the perineal tear was 77.9%, in which nullipara (40/47) accounted for 85.1%; multipara (246/320) accounted for 76.9%, most of these cases at level 1 with 93.7%. A second degree tear was only 6.3% and no cases with third or fourth degree tear. Some factors were related to perineal tear including BMI, gestational age and the baby’s weight with p<0.05. The rate of women treated with antibiotics to prevent infection was 1.4%; 0.85% of pregnant women gets swollen vaginal. 100% of women had no hematoma. 93.2% of infant followed their mother after birth.

Conclusions: The selective episiotomy brings great benefits to mothers during vaginal birth, decreases the 2nd degree tear, especially minimizes 3rd and 4th degree tear, and has no bad outcomes for infant after birth.

Key words: Selective episiotomy, perineal tear.