Does the Timing of Episiotomy Repair Influence the Incidence of Postpartum Hemorrhage? A Randomized Controlled Study

Abstract

Objective: To evaluate the effect of the timing of episiotomy repair on the incidence of postpartum hemorrhage.Methods: This randomized controlled trial included 307 pregnant women who delivered vaginally and underwent mediolateral episiotomy in atertiary-care hospital. In Group I, the repair of the episiotomy was started while the placenta was still inside. In Group II, spontaneous delivery of theplacenta was waited, and then the repair was initiated. The primary outcome was the incidence of postpartum hemorrhage. Secondary outcomeswere the mean blood loss, postpartum 24th hour hemoglobin (Hb) and hematocrit (Hct) levels, mean Hb and Hct change, and the need for transfusion.Results: The rate of postpartum hemorrhage (>500 mL) did not differ significantly between the two groups (5.2% in Group I vs. 6.5% in Group II,p=0.62). The mean blood loss did not differ significantly between the two groups (206±120 mL in Group I vs. 210±134 mL in Group II, p=0.76). Therewas no statistical difference between the two groups regarding postpartum Hb and Hct levels, mean Hb and Hct change, and the need for transfusion.Discussion: Timing of episiotomy repair has no effect on the incidence of postpartum hemorrhage in a tertiary hospital.