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ED; siotomy wou nd inf ection:
I n form ation on ep i s i otomy rates i n dev eloping countries
is very scanty. The availabl e data suggest that the us e of
episiot omy f or labou r mana ge ment i n de ve loping wor ld hospitals
may b e fa r l e s s frequ e nt than t h e rates r eporte d f r o m
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developed co untries (117 -121] . Episi otomy rate s reported from
studies in the united states, Britain, and Australia we r e
62.51 , 44 . 9 % a nd 43\ respectively [117,119, 122), c omp a r e d to
about 5 .7% o f all deliveries at a teaching h o s pita l in
Yaounde , Cameroon ( 120), a n d 0% of 2447 deliveries a t two
mater nity units i n Brazil ( 121] .
Two types of episiotomy , name ly the mid-line and medio­
l a t eral , are used i n current obstetric pra ctic e . Al t hough the y
each ha ve specific advantages and disadvantages , both are
generally co nsidered sa fe anc' in t he developed countries are
not f r e quentl y complicated by i nfection. Fo r example, in one
fo llow- up study of 7477 mid-line ep isiotomy recipients i n
Virginia, United States, on ly 7 pe r s on s wer e repor ted to have
developed an infectious c omplica tion ( 123 ) . In a Br itish s t udy
i n 1982, by Reading et e L, 13 . 4\ of 10 1 women f ollowe d - up
a fter e pisiotomy develo ped i nfe c t ion wi t h delay ed he aling
[12 4]. A recent stUdy from Australia [ 125 ), however reports a
higher infection r ate of 32. 7%, a lthough ncsc infe c tions were
described as mild. Despite i ts h i gh safety r ates, severe a nd