Abstract
Objectives: To study the epidemiological aspects, indications and short and medium term prognosis of episiotomy in the health district of Bogodogo in Ouagadougou, Burkina Faso. Materials and Method: It was a descriptive prospective study over 4 months from 1 July 2016 to 30 October 2016. It was conducted in 4 health facilities in the health district of Bogodogo in the city of Ouagadougou. The study concerned the patients who gave birth after 28 gestational age (GA) and more, vaginally with episiotomy, in the 4 health facilities and who were reviewed at the appointment of the 9th day and the 3rd month. The data were collected using a questionnaire developed for the purposes of the study, seized with a laptop, then analyzed using the Epi-info software in its 3.5.1 version of the Atlanta C.D.C. Statistical comparisons were made using the Pearson chi-square test, with a significance level of p 0.05. Results: The overall episiotomy rate was 22%. For follow-up, 248 patients were reviewed on the 9th day and 109 patients on the 3rd month. The average age of our patients was 23.1 years. The average number of pregnancies was 1.7 with nulliparous women predominating (60.5% of cases). Excision was associated with episiotomy in 92.3% of cases, with perineal narrowing in 82.5% of patients. The mediolateral episiotomy was the most performed, in 76.6% of patients. Vulvo-perineal stricture was the main indication (75% of cases). The experience during the episiotomy and the evolution following the immediate layer was marked by pain. Dyspareunia was the main difficulty in resuming sexual intercourse. Conclusion: The episiotomy rate in our study was 22%. A program of continuous improvement of the quality of care concerning episiotomy encompassing various actions (audits, training) could reduce the use of episiotomies.
Highlights
The perineum is the set of soft parts that close the pelvic excavation at the bottom [1]
Materials and Method: It was a descriptive prospective study over 4 months from 1 July 2016 to 30 October 2016. It was conducted in 4 health facilities in the health district of Bogodogo in the city of Ouagadougou
The study concerned the patients who gave birth after 28 gestational age (GA) and more, vaginally with episiotomy, in the 4 health facilities and who were reviewed at the appointment of the 9th day and the 3rd month
Summary
The perineum is the set of soft parts that close the pelvic excavation at the bottom [1]. It consists of 3 large muscle planes (superficial, medium, deep). Introduced by Sir FIELDING OULD, in Dublin in 1742 to facilitate childbirth, episiotomy is a perineotomy which is common practice [2]. It consists of the section of a part of the perineum from the posterior corner of the vulva after distension of the perineum by the foetal pole in order to facilitate the exit of the child. The advent of evidence-based medicine at the end of the last century had a strong impact on medical practices, including episiotomy [3]
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