yemenjmedYemen Journal of MedicinecoVolume 1 Issue 2MultidisciplinaryEnglishJuly - December 2022NNY20250329ArticleEpisiotomy at the Asha’ab obstetric emergency center, Aden, Yemen: Prevalence, clinical profile, and complicationsEnglishY8588Nada YusufKhanEnglishNSumaiya AbdullahNajiEnglishY10.32677/yjm.v1i2.3686Background and Objectives: Despite the controversies that prevail regarding the efficacy of episiotomy, it is still practiced widely around the world in various degrees of prevalence. This study aimed to identify and analyze the prevalence, clinical profile, and complications of episiotomy performed on women who delivered at the Asha’ab Obstetric Emergency Center. Patients and Methods: This was a cross-sectional study that involved women who had undergone vaginal delivery at the Asha’ab Obstetric Emergency Center, in Aden city, Yemen, between October 1, 2021, and March 31, 2022. Permission to conduct the study was obtained from the center’s administrative office. Results: During the study period, 858 women delivered vaginally at our center. Out of these, 443 women had had an episiotomy, representing an episiotomy prevalence of approximately 51.6%. These 443 women were enrolled in this study. The episiotomy was more common among primigravida women (n=362, 81.7%), followed by multiparous women (n=42, 9.5%). The most commonly associated medical disorder was anemia (n=167, 37.7%), followed by hypertension (n=33, 7.4%). Perineal pain (n=51, 11.5%) was the most frequently reported post-episiotomy complication, followed by perineal discomfort (n=32, 7.2%), wound infection (n=27, 6.1%), perineal bleeding (n=18, 4.1), difficulty in walking (n=9, 2.0%), wound dehiscence (n=3, 0.7%), and difficulty in defecation (n=1, 0.2%). Conclusion: The prevalence of episiotomy among women who gave birth at the Asha’ab Obstetric Emergency Center, in Aden city, Yemen, was higher than the World Health Organization recommendation, which is around 10% or less with acceptable obstetric evidence indicating the need. Further prospective large-scale studies are recommended to confirm the findings of this study.EnglishEpisiotomy, Post-episiotomy complications, Prevalence, Vaginal delivery, Yemenhttps://yemenjmed.com/admin/abstract?id=38References16191. Thacker SB, Banta HD. Benefits and risks of episiotomy: An interpretive review of the English language literature, 1860-1980. Obstet Gynecol Surv 2003;38:322-38.2. Kalis V, Laine K, de Leeuw JW, et al. Classification of episiotomy: Towards a standardisation of terminology. BJOG 2012;119:522-6.3. Graham ID, Carroli G, Davies C, et al. Episiotomy rates around the world: An update. Birth 2005;32:219-23.4. Fodstad K, Staff AC, Laine K. Episiotomy preferences, indication, and classification-a survey among Nordic doctors. Acta Obstet Gynecol Scand 2016;95:587-95.5. Marty N, Verspyck E. Perineal tears and episiotomy: Surgical procedureCNGOF perineal prevention and protection in obstetrics guidelines. Gynecol Obstet Fertil Senol 2021;46:948-67.6. Cesar JA, Marmitt LP, Mendoza-Sassi RA. Episiotomy in Southern Brazil: Prevalence, trend, and associated factors. Rev Saude Publica 2022;56:26.7. Frass KA, Al-Harazi AH. Episiotomy is still performed routinely in Yemeni women. Saudi Med J 2010;31:764-7.8. Ononuju CN, Ogu RN, Nyengidiki TK, et al. Review of episiotomy and the effect of its risk factors on postepisiotomy complications at the University of Port Harcourt Teaching Hospital. Niger Med J 2020;61:96-101. 9. Cochrane Library, Selective Versus Routine Use of Episiotomy for Vaginal Birth. Available from: https://www.cochrane.org/CD000081/PREG_ selective-versus-routine-use-episiotomy-vaginal-birth [Last accessed on 2022 Oct 02].10. He S, Jiang H, Qian X, et al. Womenand;rsquo;s experience of episiotomy: A qualitative study from China. BMJ Open 2020;10:e033354.11. Clesse C, Lighezzolo-Alnot J, de Lavergne S, et al. Statistical trends of episiotomy around the world: Comparative systematic review of changing practices. Health Care Women Int 2018;39:644-62.12. Seijmonsbergen-Schermers AE, Geerts CC, Prins M, et al. The use of episiotomy in a low-risk population in the Netherlands: A secondary analysis. Birth 2013;40:247-55.13. Levitt C, Hanvey L, Bartholomew S, et al. Use of routine interventions in labour and birth in Canadian hospitals: Comparing results of the 1993 andand;nbsp;2007 Canadian hospital maternity policies and practices surveys. J Obstet Gynaecol Can 2011;33:1208-17.14. Coulm B, Le Ray C, Lelong N, et al. Obstetric interventions for lowrisk pregnant women in France: Do maternity unit characteristics make a difference? Birth 2012;39:183-91.15. Oraif, A. Routine episiotomy practice at a tertiary care center in Saudi Arabia. Open J Obstet Gynecol 2016;6:794-7.16. Singh S, Thakur T, Chandhiok N, et al. Pattern of episiotomy use and its immediate complications among vaginal deliveries in 18 tertiary care hospitals in India. Indian J Med Res 2016;143:474-80.17. Pebolo PF, Judith A, Dan KK. Prevalence and factors associated with episiotomy practice among primiparous women in mulago national referral hospital Uganda. Int J Pregn Chi Birth 2019;5:197-201.18. Abdul-Raheem Y. Whether selective or routine episiotomy is more useful to protect anal sphincter in PRI-MIPAROUS women. Iraq J Med Sci 2012;11:26-32.19. Schantz C, Sim KL, Ly EM, et al. Reasons for routine episiotomy: A mixedmethods study in a large maternity hospital in Phnom Penh, Cambodia. Reprod Health Matters 2015;23:68-77.20. Sangkomkamhang U, Kongwattanakul K, Kietpeerakool C, et al. Restrictive versus routine episiotomy among Southeast Asian term pregnancies: A multicentre randomised controlled trial. BJOG 2020;127:397-403.21. World Health Organization (WHO). Care in Normal Birth, A Practical Guide. Geneva: World Health Organization; 1996. Available from: https:// www.who.int/making-pregnancy-safer/document/who-frh-msm-9624/en [Last accessed on 2022 Jul 26].22. Khan NY, Bawazeer S. Analysis of perinatal mortality in Aden General Hospital: A hospital-based study from Yemen. Yemen J Med 2022;1:22-6.23. Yang J, Bai H. Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives: A cross-sectional study from China. BMJ Open 2021;11:e043596.24. Hezam HS. Knowledge, attitudes, and practices toward COVID-19 among healthcare workers in Shabwah Governorate, Yemen: A cross-sectional study. Yemen J Med 2022;1:31-5.25. Carvalho CC, Souza AS, Filho OB. Prevalence and factors associated with practice of episiotomy at a maternity school in Recife, Pernambuco, Brazil. Rev Assoc Med Bras 2010;56:333-9.26. Goueslard K, Cottenet J, Roussot A, et al. How did episiotomy rates change from 2007 to 2014? Population-based study in France. BMC Pregnancy Childbirth 2018;18:208.27. Fikadu K, Boti N, Tadesse B, et al. Magnitude of episiotomy and associated factors among mothers who give birth in Arba Minch general Hospital, Southern Ethiopia: Observation-based cross-sectional study. J Pregnancy 2020;2020:8395142.28. Alayande BA, Amole IO, Olaolorun DA. Relative frequency and predictors of episiotomy in Ogbomosho, Nigeria. Internet J Med Update 2012;7:41-4.29. Goodarzi G, Rajabian S, Ahmadian M, et al. Comparing the incidence of episiotomy site infection in two groups of primiparas with and without taking prophylactic antibiotics after normal vaginal delivery referred to Bent Al-Huda Hospital in Bojnourd. J Obstet Gynecol Cancer Res 2020;5:31-8.30. Khan NB, Anjum N, Hoodbhoy ZH, et al. Episiotomy and its complications: A cross-sectional study in secondary care hospital. J Pak Med Assoc 2020;7:2036-8.31. Garala NJ, Nambiar SS. Prophylactic antibiotics in patients with episiotomy following normal vaginal delivery: A randomized clinical trial. Int J Reprod Contracept Obstet Gynecol 2019;8:3846-51.