General Obstetrics and Gynecology: ObstetricsIncidence, severity, and determinants of perineal pain after vaginal delivery: A prospective cohort study☆
Section snippets
Material and methods
A prospective cohort study was conducted at Women's College Hospital, a tertiary care perinatal unit in Toronto, Canada. After institutional research ethics review and approval, this study was carried out over an 8-month consecutive period, with subjects recruited and interviewed by one research nurse. The study population consisted of all women over the age of 18 years who were delivered of a live neonate vaginally and were in hospital for at least 24 hours after delivery.
Women participating
Results
The study population consisted of 447 women followed up for 6 weeks after vaginal delivery. Refusal to participate in the study was negligible, with only 3 women declining to participate. Grouping the women by exposure yielded 84 women with an intact perineum (control group), 220 women with first-/second-degree tears, 97 women with episiotomies, and 46 women with third-/fourth-degree tears (12 of who had a preceding episiotomy). The majority of the episiotomies (91/109) were median episiotomies.
Comment
This prospective cohort study followed 447 postpartum women for 6 weeks to define the incidence and severity of perineal pain after vaginal delivery, and to quantify the association between perineal trauma and perineal pain. Our results indicate that postpartum perineal pain is common in the initial period after delivery, regardless of perineal trauma. Increased perineal trauma was associated with greater pain scores, the choice of more severe pain descriptors, and more frequent use of narcotic
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Presented at the 17th Annual Meeting of the Society of Perinatal Obstetricians (SPO), January 20-25, 1997, Anaheim, Calif.
Supported by study grants from Canadian Anesthesia Society–Zeneca Canadian Research Award in Anesthesia and Women's College Hospital Research Foundation.