Title: Comparing the Rate of Perineal Tears with and Without Episiotomy in Primigravida Women
Abstract: Objective: To compare the frequency of perineal tears (3rd and 4th degree) with and without episiotomy in primigravida women.
 Setting: Department of Obstetrics and Gynecology at peoples Medical College Hospital (PMCH) Nawabshah.
 Duration of Study: Six month from March 2015 to September 2015.
 Study Design: Randomized control trial.
 Subject and Methods: In this study 322 primigravida women with singleton pregnancy and cephalic presentation were included. The patients were kept in labour room till the second stage of labour. The patients were divided into two groups equally. In Groups-A, right mediolateral episiotomy was performed after infiltration with local anaesthesia at the time of crowing. The Group B in which episiotomy was not given. After delivery, patients were examined for extension of episiotomy in Group A and 3rd and 4th degree perineal tear in both groups.
 Results: Mean age was 27.83±6.27 years in group A and 27.60±4.93 years in group B (p=0.724). Mean gestational age was 38.17±1.25 weeks was in group A and 38.11±119 weeks in group B (p=0.644). The rate of 3rd and 4th degree perineal tear was significantly higher in group A as compare to group B [60.87% vs. 47.83% p=0.019] and [39.13% vs. 26.09% p=0.013] respectively.
 Conclusion: Episiotomy was found to be an important risk factor for extension of the perineal tear. It should be practiced only where it is indicated like rigid perineum, any instrumental delivery and shoulder dystocia.