title: Development of chronic pain after episiotomy.
abstract: OBJECTIVE
  To analyze the incidence of chronic pain 5 months after episiotomy, as well as potential prognostic factors.
  
  
  METHODS
  A prospective cohort observational study was conducted on pregnant women age≥18 years who had undergone an episiotomy. The presence of pain was evaluated in the area of episiotomy at 24 and 48 h of delivery using a structured face-to-face questionnaire, and by telephone questionnaire at 5 months. The primary endpoint was the presence of persistent pain at 5 months. A record was made of the presence of pain at delivery, and its intensity, the presence or absence of epidural analgesia, instrumental delivery, perineal tear, and pain when episiotomy was performed, as well as the presence of dyspareunia and urinary incontinence at 5 months post-episiotomy.
  
  
  RESULTS
  A total of 87 parturient patients were included, of whom 78 completed the study. Of the patients who completed the study, 12.8% reported chronic episiotomy pain. Epidural analgesia was associated with a higher incidence of instrumental delivery and less pain at the time of episiotomy and expulsion (P<.0005, P<.02, and P<.01, respectively). Chronic pain is associated with operative delivery (P<.017), and with the presence of pain at rest at 24 and 48 h (P<.01), of wound complications (P<.026), and of dyspareunia (P<.001).
  
  
  CONCLUSIONS
  An incidence of 12.8% of women developing chronic pain after delivery with episiotomy suggests a health problem. More studies are needed to confirm our results.
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Investigación, Hospital de Valme, Sevilla, España.
authors.forename: M
authors.initials: M
authors.lastname: Turmo
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Investigación, Hospital de Valme, Sevilla, España. Electronic address: mercedes.echevarria@terra.com.
authors.forename: M
authors.initials: M
authors.lastname: Echevarria
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Investigación, Hospital de Valme, Sevilla, España.
authors.forename: P
authors.initials: P
authors.lastname: Rubio
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Investigación, Hospital de Valme, Sevilla, España.
authors.forename: C
authors.initials: C
authors.lastname: Almeida
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D059350:Chronic Pain / Q000453:epidemiology / Q000209:etiology*; D036861:Delivery, Obstetric / Q000379:methods; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D009772:Obstetrical Forceps; D011247:Pregnancy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
keywords: Chronic pain; Delivery; Dolor crónico; Epidural; Epidural partum; Episiotomy; Episiotomía; Parto