title: Rates and Indicators for Episiotomy in Modern Obstetrics - a study from Saudi Arabia.
abstract: BACKGROUND
  This observational study aimed to describe the rates and indicators for practice of episiotomy during normal labour and to compare them between women who have had one pregnancy (PG) and women who have already delivered two or more children (G2 and above).
  
  
  METHODS
  The study was conducted at Mother and Child Hospital, Buraidah from October- December 2013 as a descriptive cross sectional study.
  
  
  RESULTS
  Overall rate of Episiotomy was 51.20%. Amongst the Primigravidas all went through episiotomies however in G2 and above only 7 patients (4.69%) delivered with episiotomy. Proportions tests revealed that there were significant differences between gravidity groups on two indications of episiotomy (vaginal breech p <0.001 and previous history of perineal tear p < 0.001). G2 and above had episiotomy for breech delivery (1 of 7 = 14.29%) significantly more often than PG participants (0 of 142 = 0.0%). And G2 and above participants experienced episiotomy for previous perineal tear (2 of 7 = 28.5% as compared to none in PG No other significant differences were found on indications of episiotomy.
  
  
  CONCLUSIONS
  Episiotomy is a very common obstetric intervention (51.20%). The PG experience episiotomy significantly more often than G2 and above women. Efforts should be made to reduce its rates. This can be done by reviewing the indications and rates at repeated intervals and setting guidelines for these indications.
authors.affiliation: Qassim University, College of medicine, Buraidah, Saudi Arabia ; Department of Obstetrics and Gynecology, Qassim College of Medicine, Buraidah, Saudi Arabia.
authors.forename: Zaheera
authors.initials: Z
authors.lastname: Saadia
keywords: Episiotomy; Primigravida; Saudi Arabia; labour