Postpartum Perineal Pain in the Absence of Obstetric Anal Sphincter Injuries: A Prospective Observational Study

Abstract

OBJECTIVE The purpose of this study was to identify the prevalence of perineal pain at early postnatal period and to assess the association between maternal, obstetric or neonatal variables and perineal pain. METHODS Three hundred and six women were followed up for perineal pain with present pain intensity (PPI) and visual rating scale (VRS) components of the validated short-form McGill pain scale. Multivariate logistic regression was performed to identify which characteristics of the patients and neonates were independent determinants of perineal pain. RESULTS The incidence of perineal pain at days 1 and 7 postpartum was 88.2% and 24.9%, respectively. PPI was mild 63.1% (day 1) and 23.9% (day 7), moderate 24.2% and 1.1%, and severe 1% and 0%. VRS score was 2 (1-3) at day 1 and 0 (0-1) at day 7 postpartum, respectively. Perineal pain was more common in primiparous women with higher BMI, more maternal weight gain, received epidural analgesia, and use of episiotomy. In a multivariate logistic regression model, only episiotomy predicted the pain at day 1 postpartum (RR=2.05, 95% CI 0.95-4.42) suggesting that women with mediolateral episiotomy experienced more intense pain than women with median episiotomy. CONCLUSIONS In the absence of obstetric anal sphincter injuries, although perineal pain during the early postnatal period is prevalent, the intensity is slight. Moreover, the use of episiotomy is associated with more perineal pain than other perineal trauma

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This paper was published in Insights Publisher.

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Licence: https://creativecommons.org/licenses/by-nc/4.0