Does early repair of episiotomy decrease postpartum blood loss: A randomized clinical trial

Abstract

Objective. To assess whether early repair of episiotomy before expulsion of placenta affects postpartum blood loss.

Methods. Patients who had normal vaginal delivery with episiotomy were enrolled in the study. One hundred and twenty who were randomly allocated to either episiotomy repair before (Group 1: 60) or after spontaneous placental expulsion (Group 2: 60) had mediolateral episiotomy. Postpartum blood loss was measured with calibrated collecting bags, placed under the women immediately after the birth. Amount of the blood loss 1 h after the delivery was recorded and the two groups were compared for postpartum blood loss as a primary outcome. After the normality analysis with Kolmogorov–Smirnov Test, we used Mann–Whitney U test for comparing groups. The chi-square test was used for comparing presence of postpartum hemorrhage.

Results. Mean blood loss was slightly higher in Group 2 (259.5 ± 148.9 vs. 310.6 ± 195.2, P = 0.21) but the difference was not statistically significant. There was no statistically significant differences in hemoglobin and hemotocrit levels (ΔHb and ΔHct) in both groups at admission and postpartum.

Conclusion. Early repair of episiotomy before expulsion of placenta has a minor positive effect on postpartum blood loss.

Keywords:

• Episiotomy
• expulsion of placenta
• blood loss
• collecting bag

Acknowledgement

The authors thank Gynuity Health Project for their technical support.