Perineal Pain

Pain in the perineal region after birth is mainly due to surgical incision termed as episiotomy or due to perineal tear. Episiotomy at the time of vaginal delivery is a common surgical incision to the perineum in obstetrical procedure. It is done during second stage of labour. Approximately 33% women with the vaginal delivery had episiotomy by the year 2000. Episiotomy is more common with operative than spontaneous vaginal deliveries. Perineal pain in the early postpartum period has been reported to be most common cause of maternal morbidity. The liberal use of episiotomy causes perineal damage and it may increases risk of incontinence and sexual discomfort. Pain following episiotomy appears to be universal. The mother undergoing episiotomy is characterized by greater blood loss with risk of improper wound healing and increased pain during early puerperium. Pain and discomfort from perineal trauma can be a distressing experience of early motherhood and leads to discomfort when sitting, standing, walking and moving. The provision of safe and effective pain relief for perineal trauma using therapeutic ultrasound, rectal analgesia, oral analgesics, non-pharmacological application such as cooling gel pads are recommended but lack of evidences. Therapeutic ultrasound and cooling maternal gel pad are said to be used in the first few days after vaginal delivery to reduce perineal pain. The mechanism by which therapeutic ultrasound may improve tissue repair and reduce pain have been reviewed by Dyson. (Mahishale A, Chougala A, Patted S (2013) Effect of Therapeutic Ultrasound and Maternal Cooling Gel Pad for Perineal Pain Following Vaginal Delivery with Episiotomy.)

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Last date updated on September, 2024