Postpartum Perineal Pain and its Management in Tertiary Level Hospitals of Dhaka, Bangladesh: An Undervalued and Poorly Studied problem
- Background: Effective and timely management of post partum pain is mandatory in order to promote healthy maternity. Severe perineal pain can even distract the mother and therefore interrupt the initial bonding process between mother and baby. Therefore, efficient perineal pain management during postpartum period of delivery is important for safe motherhood.
- Objective: To identify the proportion of mothers complaining post partum perineal pain and to detect the use of therapeutic measures for the relief of perineal pain during the first 24 hours of delivery in tertiary care hospital of urban Dhaka, Bangladesh.
- Methods: A cross sectional study was conducted in the post natal wards of both Dhaka Medical College and Sir Salimullah Medical College from November to December, 2015. Data were collected through interviews with 237 women who had normal vaginal delivery within the last 24 hours of data collection to evaluate the proportion of post-partum perineal pain and its management practices in those two tertiary level government hospital.Patients’ files were reviewed as a part of document analysis to know the therapeutic measures used for pain relief.
- Results: About 60% mothers complained about perineal pain during the first 24 hours of normal vaginal delivery in both hospitals. Among those 92.86% from them reported to have an episiotomy with extension, 70.21% had spontaneous laceration, followed by 64.71% who had an episiotomy with p-value 0.000, 95% confidence interval. As for management of perineal pain after delivery, 84.44% of them received pharmacological treatment, the most frequent of which were combination of NSAID and paracetamol. Among the non-pharmacological treatment, sitz bath was commonly prescribed. Not prioritizing the perineal pain as a problem often acts as reason for not getting treatment.
- Conclusion: Mothers should be offered with timely management of perineal pain relief. Alternative options like non pharmacological treatment can be offered based on scientific evidence. Mothers need to be made aware of what to expect for pain relief as well as health care providers must be trained in order to timely manage the perineal pain.
Key words: Perineal pain, perineal pain management, therapeutic measures.
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