Effectiveness of water labor on the degree of perineal injury and episiotomy in primiparous women – A pilot study

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Kavitha. V., P. Senthil Selvam, M. Manoj Abraham, Tushar J. Palekar, M.S.Sundaram

Abstract

Background: Water immersion during the first stage of labor is a noninvasive and nonpharmacological form of pain relief. The aim of this study is to investigate the effect of immersion in warm water tub on the degree of perineal injury and the incidence of episiotomy.
Method: A total of 30 primiparous women were selected for the study. The subjects were randomized into either the experimental or control group. The women during labor were monitored thoroughly one hour once on the following parameters such as maternal body temperature, heart rate, respiratory rate, blood pressure, fetal heart rate, and CTG. The laboring women in the experimental group were asked to leave the pool on full dilation and push the baby on the bed in any position they wish to. The women in the control group are informed that they can push the baby in whatever position they are comfortable with on the bed. The perineum was examined and if necessary, tears were sutured. Episiotomy was sutured in 3 layers by the gynecologist.
Results: The total number of patients were equally divided into experimental and control group. In the experimental group 20% of the subjects had no tear of the perineum, 25% subjects had first degree tear, 15% women had second degree tear, and three women had third degree perineal tear and one woman had episiotomy. Most of the women in the control group were lying down on their back. In the control group, 70% women had episiotomy, two had second degree tear and three had third degree tear.
Conclusion: the perineal morbidity is significant lower in primiparous women in the experimental group than in the control group.

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