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VAGINAL BIRTH TRAUMA AND PRIMIPARITY; EXPERIENCE AT A TERTIARY CARE HOSPITAL
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Objective: To determine the effects of perineal tears during vaginal birth in primiparouswomenMethodology: This Cross-Sectional Study was conducted at the Department of Obstetrics& Gynae, Unit I, LUMHS, Jamshoro, from October 27, 2022 to April 26, 2023. Allwomen who fulfilled the inclusion criteria and admitted in emergency in labour wardwere included in the study. Informed written consent was taken after explaining theprocedure, risks and benefits. Data were entered in predesigned proforma containingbasic biodata, sociodemographic details, gestational age, mode of onset of labour(spontaneous or induced), vaginal delivery with episiotomy, instrumental vaginaldelivery with perineal tears, type I, II, III and IV- degree. All the data were collected andanalyzed on SPSS version-21.Results: The mean maternal age was 24.86±5.70 years. Among women with perinealtears, instances of bleeding were noted in 21.1% of 1st degree tears and 24.6% of 2nddegree tears. Anesthesia-related issues were reported in 7.0% and 14.9% of cases,respectively. Puerperal sepsis was documented in 4.4% of 1st degree tears and 0.9% of2nd degree tears. For 3rd degree tears, bleeding was observed in 2.6% of cases, withanesthesia-related complications reported in 5.3% and puerperal sepsis in 2.6%.Rectovaginal fistula was not observed in any tear degree, while vesicovaginal fistula wasdocumented in 0.9% of 1st degree tears and 4.4% of 2nd degree tears. The mean lengthsof hospital and ICU stays were 24.76 ± 15.73 hours and 3.26 ± 1.41 hours, respectively.In-hospital mortality was noted in 3.3% of participants, and perineal tears were observedin 37.6% of cases.Conclusion: The bleeding and anesthesia-related issues were more common in 2nddegree tears compared to 1st degree tears. Puerperal sepsis was relatively rare but morefrequent in 1st degree tears. Vesicovaginal fistula occurred more frequently in 2nddegree tears. Mortality was relatively low.Keywords: Perineal Tears, Primiparity, Vaginal Birth, Morbidity, Mortality
Society of Obstetricians and Gynaecologists of Pakistan
Title: VAGINAL BIRTH TRAUMA AND PRIMIPARITY; EXPERIENCE AT A TERTIARY CARE HOSPITAL
Description:
Objective: To determine the effects of perineal tears during vaginal birth in primiparouswomenMethodology: This Cross-Sectional Study was conducted at the Department of Obstetrics& Gynae, Unit I, LUMHS, Jamshoro, from October 27, 2022 to April 26, 2023.
Allwomen who fulfilled the inclusion criteria and admitted in emergency in labour wardwere included in the study.
Informed written consent was taken after explaining theprocedure, risks and benefits.
Data were entered in predesigned proforma containingbasic biodata, sociodemographic details, gestational age, mode of onset of labour(spontaneous or induced), vaginal delivery with episiotomy, instrumental vaginaldelivery with perineal tears, type I, II, III and IV- degree.
All the data were collected andanalyzed on SPSS version-21.
Results: The mean maternal age was 24.
86±5.
70 years.
Among women with perinealtears, instances of bleeding were noted in 21.
1% of 1st degree tears and 24.
6% of 2nddegree tears.
Anesthesia-related issues were reported in 7.
0% and 14.
9% of cases,respectively.
Puerperal sepsis was documented in 4.
4% of 1st degree tears and 0.
9% of2nd degree tears.
For 3rd degree tears, bleeding was observed in 2.
6% of cases, withanesthesia-related complications reported in 5.
3% and puerperal sepsis in 2.
6%.
Rectovaginal fistula was not observed in any tear degree, while vesicovaginal fistula wasdocumented in 0.
9% of 1st degree tears and 4.
4% of 2nd degree tears.
The mean lengthsof hospital and ICU stays were 24.
76 ± 15.
73 hours and 3.
26 ± 1.
41 hours, respectively.
In-hospital mortality was noted in 3.
3% of participants, and perineal tears were observedin 37.
6% of cases.
Conclusion: The bleeding and anesthesia-related issues were more common in 2nddegree tears compared to 1st degree tears.
Puerperal sepsis was relatively rare but morefrequent in 1st degree tears.
Vesicovaginal fistula occurred more frequently in 2nddegree tears.
Mortality was relatively low.
Keywords: Perineal Tears, Primiparity, Vaginal Birth, Morbidity, Mortality.
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