Paracetamol as Analgesia Following Spontaneous Vaginal Delivery: Reappraisal of Practice

Abstract

Background: We aim to determine the prevalence of perineal pain following postpartum vaginal delivery, the requirement of paracetamol as analgesia, and its associated factors. Methods: The study was performed from December 14, 2020, until February 14, 2021, in a single tertiary centre in northwest Malaysia. The pain score was assessed immediately postpartum and every six hours for the next 48 hours, and the requirement for paracetamol as analgesia was documented. Maternal sociodemographic data and baseline clinical details associated with the requirement for paracetamol were analysed. Results: A total of 285 study participants were included. The majority (93.0%) were Malays, with a mean age of 31.0 6.08 years. Majority of the women delivered their second child (36.1%) with a first-degree tear (46.7%). The majority neither required any analgesia within the first few hours of delivery in the labour room (71.3%) nor in the next 48 hours of ward observation (54.4%). The mean pain score following spontaneous vaginal delivery in the labour room was 4.0 1.07, while the mean pain score in the ward was 2.8 ± 1.05 (p<0.001). Logistic regression analysis determined that maternal weight (cOR: 1.02, 95% CI: 1.01, 1.04) and episiotomy (cOR: 3.28, 95% CI: 1.52, 7.08) were significantly predictive of paracetamol requirement as analgesia. Conclusion: Most of our population did not require oral analgesia in the postpartum period. However, the identification of susceptible individuals may guide clinicians to have a targeted approach for early management to ensure a positive birthing experience for all mothers.