A comparative study on aftereffects of perineum injury

Abstract

Purpose
The purpose of this study is to clarify if there is a difference in aftereffects (perineumpain, pain, difficulties in urination or daily life) between puerperal women who received an episiotomy and those who experienced a second degree spontaneous perineum laceration, which is equal to an episiotomy.
Method
A questionnaire survey was conducted in three hospitals within Tokyo metropolitan area in Japan on the fourth or fifth day after childbirth and 165 primiparous women who had a aginal and full-term delivery participated.
They met the requirements of the study and were classified into three categories: women who received episiotomies, those with a first degree laceration, and those with a second degree laceration. 147 responses (89.1%) were valid and analyzed statistically.
Results
1. The result of visual analogue scale showed no difference in the degree of pain (discomfort) among those three categories on the day of the delivery, the first and the third day postpartum. The pain was significantly alleviated from the day of childbirth to the following day for those with natural tears but no such relief was found for those receiving episiotomies.
2. At the early stage of puerperal period, more than half of the participants in each category recognized the urination difficulty and decline of micturition desire. There was no significant difference between them.
3. In comparison of difficulties in daily life, those with episiotomies found it more difficult to shift their standing position to a sitting posture and to fall asleep than those with a first degree laceration. No difference was shown between those with a second degree laceration and those in the other two categories.
Conclusion
There was no significant difference in aftereffects between women who had episiotomies and those with a second degree laceration. It cannot be asserted that the aftereffects of a second degree laceration are more serious than those of an episiotomy.