title: Trends and determinants of episiotomy at the University of Nigeria Teaching Hospital (Unth), Enugu, Nigeria.
abstract: BACKGROUND
  Episiotomy is the most commonly performed obstetric procedure. The indications and efficacy are poorly established and its practice has remained controversial.
  
  
  OBJECTIVE
  To determine the rate and the determinants of episiotomy in the parturients at the UNTH, Enugu.
  
  
  METHODS
  A five year retrospective review of episiotomy at UNTH Enugu between 1st January, 2000 and 31st December, 2004.
  
  
  RESULTS
  Out of 3032 vaginal deliveries, 1201 women had episiotomy during vaginal delivery, giving a rate of 39.6%. The rate fluctuated between 38.7% in 2000 to 32.7% in 2004. The risk of receiving episiotomy is significantly higher among primigravidae than multigravidae [OR = 10.92, (95% CI = 8.98,13.28)]. Similarly, macrosomia (birth weight > 4 kg) significantly increases the risk of episiotomy [OR = 0.096, (95% CI = 0.06, 0.15)]. Women who had instrumental or destructive vaginal delivery are significantly more likely to receive episiotomy than those who had spontaneous vaginal delivery [OR = 0.13 (95% CI = 0.07, 0.26)]. The postpartum blood loss is significantly higher among women that received episiotomy than those who did not [t = 42.161, P > 0.0001].
  
  
  CONCLUSIONS
  The rate of episiotomy in UNTH, Enugu is high. Primigravidity, macrosomia and instrumental deliveries are factors associated with increased risk of episiotomy. Knowledge of these risk factors will guide in predicting episiotomy among paturients in labour ward.
authors.affiliation: Department of Obstetrics & Gynaecology, University of Nigeria Teaching Hospital (UNTH) Enugu Nigeria. ubabiketochukwu@yahoo.com
authors.forename: T C
authors.initials: TC
authors.lastname: Okeke
authors.forename: E O V
authors.initials: EO
authors.lastname: Ugwu
authors.forename: O A
authors.initials: OA
authors.lastname: Okezie
authors.forename: J O
authors.initials: JO
authors.lastname: Enwereji
authors.forename: C C K
authors.initials: CC
authors.lastname: Ezenyeaku
authors.forename: L C
authors.initials: LC
authors.lastname: Ikeako
mesh_terms: D001724:Birth Weight; D004841:Episiotomy / Q000009:adverse effects / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D009549:Nigeria; D010298:Parity; D036801:Parturition; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies