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 (DeltaHb and DeltaHct) 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.