The Impact of Labor Complications on Episiotomy Rates in a Rural Ethiopian Hospital (2019): Exploring Links Between Vacuum Deliveries and Low Apgar Scores

<h2><strong>Abstract</strong></h2>\n<p><strong>Background</strong></p>\n<p>Episiotomy rates remain high in some regions, despite questions about its benefits. This study investigates the prevalence of episiotomy in a rural Ethiopian hospital (2019) and explores links between episiotomy use, labor complications (vacuum deliveries), and newborn health (low Apgar scores).</p>\n<p><strong>Methods</strong></p>\n<p>A cross-sectional study reviewed 300 vaginal deliveries at Batu General Hospital in January-March 2019. We analyzed data on maternal age, mode of delivery, neonate sex, first-minute Apgar score, and episiotomy use.</p>\n<p><strong>Results</strong></p>\n<p>Episiotomy was performed in 26% (78/300) of deliveries. Mothers who delivered with vacuum assistance were 15.17 times more likely to experience episiotomy compared to those with spontaneous vaginal delivery. Deliveries with low Apgar scores had 6.11 times higher odds of episiotomy compared to normal Apgar scores.</p>\n<p><strong>Conclusion</strong></p>\n<p>This study highlights a high episiotomy rate in this setting. Labor complications, particularly those requiring instrumental deliveries and resulting in low Apgar scores, are significantly associated with episiotomy use. Further investigation is needed to determine if reducing unnecessary episiotomy is feasible while ensuring safe deliveries for mothers and newborns in this context.</p>\n<p><strong>List of Acronyms and Abbreviations</strong></p>\n<p>ANC - Ante Natal Care</p>\n<p>APGAR score - Appearance, Pulse, Grimace, Activity, Respiration</p>\n<p>AOR - Adjusted Odds Ratio</p>\n<p>CI - Confidence Interval</p>\n<p>LBW - Low Birth Weight</p>\n<p>NVD - Normal Vaginal Delivery (alternative to SVD)</p>\n<p>OR - Odds Ratio</p>\n<p>SGA - Small for Gestational Age</p>\n<p>SROM - Spontaneous Rupture of Membranes</p>\n<p>SVD - Spontaneous Vaginal Delivery</p>\n<p>VAC - Vacuum Assisted Delivery</p>