Evaluation of the practice of episiotomy in public and private settings in Dakar, Senegal: a case-control study from 2019 to 2021

Objectives: To evaluate the practice of episiotomy between the public and private sectors. Methodology: This was a case-control study carried out in the maternity ward of the Philippe Maguilen SENGHOR health center and the Madeleine Clinic from January 1, 2019 to December 31, 2021 on patients with a pregnancy of more than 22 weeks of amenorrhea who gave birth vaginally. Results: Over a period of 3 years, we recorded 14,106 vaginal deliveries in the public sector and 2083 in the private sector. The frequency of episiotomy in both centers was about the same, around 29%. Patients in the private sector were older with a higher average parity. According to Burgundi's classification, his practice is roughly equivalent in both structures for all groups except group 7 where the practice is about 3 times higher in the private sector (p=0.0002); It is in the majority for group 2b in both centres (p<0.005). Conclusion: Our results imply an adaptation of the training of the medical profession and midwives for a reduction in episiotomy and the promotion of comparative studies between the private and public hospital sectors in order to harmonize the actions to be followed. Keywords: Episiotomy, public, private, Dakar.