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.)
Last date updated on September, 2024