4.2 Main findings
The overall episiotomy rate in Kasr Alainy was found to be 64%, which
is higher than the rate recommended by the WHO (10%). The incidence in
primigravid patients is 97%. Further research is necessary to discern
the causes behind the elevated incidence among this patient group.
Potential reasons include patient and practice related factors. Patient
factors could include rigid perineum, prolonged second stage of labor,
and other clinical indications, most commonly; instrumental deliveries,
fetal distress, history or risk of OASIS (obstetric anal sphincter
injuries), large fetus, and atypical presentations[16]. Practice
related factors include the lack of time due to the hospital capacity
being fully utilized, understaffing, high patient flow or hospital
protocols. A study in China found the practice of episiotomy to be
caused by previous training, the experience of practitioners and local
norms rather than the latest medical evidence[17].
It was found that multigravida patients had an episiotomy incidence rate
of 52%. Although this incidence rate is significantly lower than that
of primigravid patients, it still exceeds the World Health
Organization’s recommended rate of 10%. The factors examined among the
multigravida patient sample were found to be statistically significant
and clinically relevant. These findings suggest that the studied factors
specifically influence the decision-making process regarding the
performance of episiotomies in multigravida patients. Possible
explanations for the incidence rate among multigravida patients being
less than primigravid patients include; a decreased likelihood of having
a rigid perineum, shorter labor durations, or variations in local norms
and protocols.