Is It Necessary to Suture All Lacerations After a Vaginal Delivery?

Authors

  • Martina Lundquist RNM,

    1. Martina Lundquist and Ann Olsson are from the Delivery Ward, and Margareta Norman is Head of the Delivery Department of the Department of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital, Danderyd; and Eva Nissen is from the Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.
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  • Ann Olsson RNM,

    1. Martina Lundquist and Ann Olsson are from the Delivery Ward, and Margareta Norman is Head of the Delivery Department of the Department of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital, Danderyd; and Eva Nissen is from the Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.
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  • Eva Nissen RNMTD, PhD,

    1. Martina Lundquist and Ann Olsson are from the Delivery Ward, and Margareta Norman is Head of the Delivery Department of the Department of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital, Danderyd; and Eva Nissen is from the Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.
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  • Margareta Norman MD, PhD

    1. Martina Lundquist and Ann Olsson are from the Delivery Ward, and Margareta Norman is Head of the Delivery Department of the Department of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital, Danderyd; and Eva Nissen is from the Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.
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Address correspondence to Martina Lundquist, Department of Obstetrics and Gynecology, Danderyd Hospital, 182 88 Danderyd, Sweden.

Abstract

Background:Midwives tend to leave minor perineal lacerations to heal spontaneously, and clinical experience and studies show that women can suffer from their stitched lacerations. The study purpose was to determine any differences in the healing process and experience of minor perineal lacerations when they were sutured or not sutured.Methods:Eighty term pregnant primiparas with minor perineal lacerations of grades I–II were randomized after childbirth. The experimental group was nonsutured and the control group was sutured. A follow-up examination was performed at 2 to 3 days, 8 weeks, and 6 months after the delivery. Participants were asked about the type of discomfort, and the effect of the laceration on breastfeeding and sexual intercourse.Results:No significant differences were found in the healing process. The type of pain differed between the groups, but the amount of discomfort was the same. The sutured group had to visit the midwife more often because of discomfort from the stitches. Sixteen percent of the women in the sutured group, but none in the nonsutured group (p= 0.0385), considered that the laceration had had a negative influence on breastfeeding.Conclusions:Minor perineal lacerations can be left to heal spontaneously. The benefits for the woman include the possibility of having a choice, avoiding the discomfort of anesthesia and suturing, providing positive affects on breastfeeding.

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