Journal of Life Science and Biomedicine  
J Life Sci Biomed, 9 (5): 122-125, 2019  
License: CC BY 4.0  
ISSN 2251-9939  
Analysis of the post-partum vaginal repair by  
injecting platelet-rich plasma; a study undertaken  
in Saudi German hospital K.S.A  
Dr. Hassan El Motawkel Ala Allah HASSAN SOLIMAN  
HOD & Consultant Obstetrics & Gynecology, Saudi German Hospital, Aseer, KSA.  
Corresponding author’s Email:  
Research Article  
PII: S225199391900019-9  
Aim. The research was based on the objective of vaginal recovery after vaginal delivery of  
women. PRP was used to determine whether the effects of the injecting PRP on vagina made  
any difference on vaginal prolapse repair or not. Therefore, the primary goal was to find the  
application of the PRP on the case of vaginal tear recovery of the mothers. Methods. The  
observational approach was utilized to conduct the following research. We examined  
(p=210) participants, while study duration was 10 months from November 2017 to August  
2018. Results. The outcomes were 100% positive in the researcher’s cohort since all the  
participants responded well while recovered fast than the usual estimated time. Conclusion.  
Injecting PRP for repairing vaginal tear is considered to be optimizing for the general  
medical background patients whereas, for the long-term follow-up, the study requires to get  
the large numbers of participants in order to make the research generic.  
Rec. 06 June 2019  
Rev. 24 August 2019  
Pub. 25 September 2019  
Vaginal Tear,  
Vaginal Repair,  
Platelet-Rich Plasma,  
Gynecological Study  
During the vaginal delivery, it is common to have perineal postpartum tear due to stretching of the vagina. It  
usually causes the tear of vaginal layers which eventually causes the temporary injury [1]. The degrees of  
vaginal tears are divided into 4 categories. While these degrees depend upon the severity of the tear. In the first  
degree tear, it includes the tear of vaginal mucosa and the connective tissue [2]. In the second degree tear, it  
involves the tear of vaginal mucosa and connective tissue along with the underlying muscles. For the third  
degree tear, it involves the complete transection of an anal sphincter [3-5]. And the last degree tear includes the  
tear of rectal mucosa [6]. A woman may suffer from any of these after delivery while just how there are several  
degrees of injury [7], there are different method for its recovery as well [8, 9].  
The following research is based on the postpartum vaginal repair by injecting Platelet-rich plasma (PRP).  
The primary objective of the research study is to analyze and evaluate the use and benefits of PRP in order to  
know its significance and in the area of postpartum vaginal repair.  
Ethical approval  
The review board and ethics committee of Saudi German Hospital, Aseer approved the study protocol and  
informed consents were taken from all the participants.  
The observational study method was implied in the following research. The study was undertaken at tertiary  
referral unit in K.S.A. Saudi German Hospital, Aseer. Whereas the participants were under observation for the  
research purposes. The participants for the research comprised of 210 laboring women between 22-46 years old.  
The study includes some of the significant limitations which are significant to come in the observation.  
Those are given as follow:  
Citation: Hassan Soliman HE-MAA 2019. Analysis of the post-partum vaginal repair by injecting platelet-rich plasma; a study undertaken in Saudi German  
hospital K.S.A. J Life Sci Biomed, 2019; 9(5): 122-125;  
The observational study lacks in providing the conclusive results or the authentic evidence as a result.  
Moreover, date limitations also play their role in making evidence weak. In order to overcome these limitations,  
it is essential to conduct a randomized controlled trial. The sample size of the participants limits the research to  
get appropriate conclusion and generalized outcome. For that reason, it is essential to carry the evidence-based  
research along with the large sample to make the outcomes generalized.  
Procedure and Analysis  
The following study was undertaken in the time period of 10 months in which 210 laboring women  
between the ages of 22 to 46 were the participants. These participants were critically observed in order to  
analyze the application of PRP in vaginal repair.  
The infiltration was made by using 20ml of Lidocaine (2%) with 1 Amp Vasopressin 20 IU + 30 ml Normal  
Saline +/- Sedation Inj. Dormicum 15mg/3ml. the major factors that have the significant role in the observational  
study include The Surgical Technique including Vaginoplasty and Perinorraphy which depends upon pre-  
delivery evaluation of vaginal laxity, widening, distance between the vagina and anus, any varicosities and mass.  
Following the experimental procedure, the participants were provided the sedation and after that the  
vasoconstrictor and local Analgesia Solution in both vaginal wall and perineum. The re-evaluation after the  
delivery was performed which further included: Careful dissection of the vaginal wall equally starting from the  
apex till the mucocutaneous junction at the introitus, two to three stitches at the deep and superficial perineal  
muscles and levator ani muscles and removal of the all excess vaginal tissues. After that the procedure  
proceeded by suturing the vaginal wall starting from the apex until the hymen ring and the one deep as well as  
a high stitch to approximate the bulbospongiosus muscle on both sides. The suturing was completed until the  
mucocutaneous junction while two or three stitches were tied muscles and interrupted stitches including  
subcuticular stitches of the perineal area. After completion of the repair process, inject ± 4.5 5ml of PRP which  
was already prepared at the time of delivery after extraction of 8-9 ml blood from the patient and put in the  
tube and centrifuge for 5 minutes to separate the PRP from the whole blood. Afterwards the PRP is injected to  
subcutaneous and subvaginal for further experimental approach. In the last compression and assurance of the  
heamostasis by vaginal back after catheterization, analgesia (mainly non-steroidal anti-inflammatory supple-  
ments) was done.  
Furthermore, the statistical measurements of the parity and the age of participants are elaborated in  
tables 1 and 2. Any participant with any medical disorders e.g. hypertensive, diabetic, hypothyroid was well  
controlled before implication of the treatment. Thirteen of the women were diagnosed with hypertensive but  
not pre-eclampsia symptoms. Seventeen of them were Anemic with the Hb below 10.5. 41 of the women were  
diagnosed diabetic while the experiment was obtained on total 210 numbers of women from 22 to 46 years of  
age. Weight of the participants was measured between 63 to 114 kg.  
Table 1. Characteristics of the participants of the study  
22-46 years  
69-117 kg  
Medical disorder  
14.76 %  
6.19 %  
27.14 %  
0.95 %  
Multiple medical disorder  
Diabetic and hypertensive  
Diabetic and hypothyroid  
Hypertensive and hypothyroid  
5.23 %  
1.42 %  
3.33 %  
P1 P5  
P6 P11  
66.19 %  
33.80 %  
Citation: Hassan Soliman HE-MAA 2019. Analysis of the post-partum vaginal repair by injecting platelet-rich plasma; a study undertaken in Saudi German  
hospital K.S.A. J Life Sci Biomed, 2019; 9(5): 122-125;  
Table 2. Vaginal prolapse of the participant  
Vaginal prolapse  
19.52 %  
Minor degree (1st degree tear)  
Moderate degree (2nd degree tear)  
Severe degree (3rd degree tear)  
52.85 %  
22.61 %  
After deeply analyzing the outcomes and observations made on the participant in ten months’ time period, the  
researcher concluded the approach towards vaginal repair immediately after delivery is effective and more  
feasible. Furthermore, it adverts that the addition of vasopressin and lidocaine infiltration helps to prevent  
heavy blood loss and leads to prolong the analgesic effect. There were multiple more advantages observed  
during the observation like more analgesics time, cosmetic appearance, less infection and less dehiscence of the  
wound. Therefore the participant of the study (p=210) along with mediocre medical background responded well  
to the experimental vaginal repair experiment. Hence, the study was proved to be 100% successful whereas, for  
long-term follow-up, there is a need for large sample of participants for further evaluation and comparison.  
The average size of a baby’s head is 11.4 centimeters in diameter. The average diameter of a woman’s  
vagina (according to a study) is 2.1 to 3.5 centimeters [10]. This initiates the scenario of complication in delivery  
[9-12]. Perhaps, some of the women do not require vaginal tear to deliver a child but some of them experience  
different degrees of the vaginal tear [13]. The process of repairing vagina take long while the sensitivity of area  
makes it critical to handle [14]. That is why different approaches are usually followed in order to speed up the  
repair of an organ [15]. Usually the initial steps for the tear include suturing and stitches after that different  
medicines are used to cure the stitches further [13, 15]. This particular research follows the idea of injecting PRP  
for speeding up the process of vaginal repair while the observational study was prioritized on the basis of its  
advantages defined as follow:  
Through the PRP approach for vaginal repair, there is a significant decrease in blood loss as well as time of  
the repair [15, 16]. It provides more analgesics time while providing more cosmetic appearance later on [15].  
There are also very fewer chances of infection as dehiscence of the wound as per the results advert. For the  
concept of PR, the Plasma is the portion of liquid which contains whole blood. It has the large of water and  
proteins, platelets to circulate within the body for healing purpose [14]. Platelet activation plays a key role in the  
body's natural healing process [15]. Its major application is to heal the tissues of the body and has been used for  
multiple medical purposes in history.  
The applications of Platelet-rich plasma (PRP) was proved to be significant for the vaginal repair after first,  
second and third-degree tear of women during vaginal delivery. The necessary measurements were made to  
check the medical condition of the study participants and the approach towards new treatment was applied to  
them in order to observe its outcomes. The researcher took the consent of the laboring women before the  
experiment and it was conducted with all security measures from healthcare perspective.  
Funding Statement  
This research did not receive any specific grant from funding agencies in the public, commercial, or not-  
for-profit sectors.  
Conflict of interests  
Authors do not have any conflict of interests.  
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Citation: Hassan Soliman HE-MAA 2019. Analysis of the post-partum vaginal repair by injecting platelet-rich plasma; a study undertaken in Saudi German  
hospital K.S.A. J Life Sci Biomed, 2019; 9(5): 122-125;