عنوان المقالة:التدخل الجراحي مقابل التدخل التحفظى لتمزقات العجان التي تحدث أثناء الولادة الطبيعية Surgical Repair Versus Non-Surgical Management of Spontaneous Perineal Tears that Occur during Child birth
Abstract Background: Trauma to the perineum of varying degrees constitutes the most common form of obstetric injury. In clinical practice, these tears are often sutured. However, small tears may also heal well without surgical interference. Aim: The aim of this study was to investigate whether surgical intervention for first and second-degree perineаl tears sustained during childbirth could аffect primary and secondary outcome compаred to conservative manаgement. Subject & Methods: Cohort Prospective study conducted in Obstetrics and Gynecological Department at Helwan General Hospital. One hundred women; 50 of them were using surgical repair by using suture for perineal tears compared with 50 ones leaving the wound to heal spontaneously, by using conservative management. Α Structured-Interviewing-Questionnaire-sheet, Physical-assessment-sheet, Labor-outcomes-sheet, McGill-pain-rating-scale, and follow-up sheet were used for data collection. Results: The majority (86.0 %) of women with surgical repair suffering from severe pain compared to 24.0% non-surgical repair group (P<0.05). Throughout a period of 6 weeks to 3 months; 90.0% of women of surgical group reported wound healing, compared to only 46.0% of non-surgical repair group, also, sexual life in term dyspareunia has affected among 16.0% of surgical group compared to 2.0% in non-surgical repair group, (p<0.05). The outcome, after 3 to 6 months, as regard tear state and complications among women in the two studied groups, it is evident that 74.0% of women in the non-surgical repair group had wound break occurred compared to 6.0% of surgical wound repair had the same complaint, (p<0.05). Conclusion: There are evidence and significant differences between the two groups regarding type and intensity of pain. Moreover, there is evidence that the perineal tear did not heal so well in women up to six weeks postpartum who are not sutured. Recommendations: information sheets or booklets, that the mother can take home, should be distributed for postpartum women before their discharge to act as a reference for perineal tear and its proper care.
أ.د. حنان الزبلاوى حسن | Hanan Elzeblawy Hassan | 10450