A Prospective Observational Study of Lower Genital Tract Injuries in Multipara during Vaginal Deliveries in a Tertiary Institution
Authors/Creators
- 1. Professor & HOD, Department of Obstetrics & Gynaecology, Rangaraya Medical College, Kakinada, Andhra Pradesh, India
- 2. Senior Resident, Department of Obstetrics & Gynaecology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
- 3. Assistant Professor, Department of Obstetrics & Gynaecology, Rangaraya Medical College, Kakinada, Andhra Pradesh, India
Description
Background: This study was conducted to assess the incidence of maternal lower genital tract injuries, study the various types of maternal lower genital tract injuries during vaginal delivery and to assess complications and morbidity due to lower genital tract injuries. Methods: This was a hospital-based prospective observational study conducted among 100 female patients admitted to the labour room for vaginal delivery in the Government General Hospital Kakinada, from December 2019 to October 2021 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: Majority of genital tract injuries occurred in the second gravida of about 69%, 1% of cases belong to the fifth gravida. 76% of cases are booked and 24% are unbooked. Among the women with co-morbidities, the frequency of genital tract injuries in preeclampsia was 10%. The frequency of genital tract injuries in GDM was 2%. The maximum number of genital tract injuries occurred in women with a normal duration of labour (78%). 62% of cases have a birth weight of 3.6-4 kg. 6% of cases have a birth weight of 2.5-3 kg. 60% of cases of genital tract injuries occurred during spontaneous delivery. 40% of cases of genital tract injuries occurred during outlet forceps delivery. 44% of cases were 2nd degree perineal tears. 2% of cases were cervical lacerations. Conclusion: Skilled birth attendants in labour, vigilant labour monitoring, identifying risk factors such as perineal injuries in previous deliveries, a big baby, a timely episiotomy, a proper Ritgen’s manoeuvre, timely and adequate suturing, the allocation of medical personnel depending on risk factors, the provision of emergency obstetric care services that are accessible and affordable, and perineal care in the postnatal period help a lot in reducing the rate of genital tract injuries and complications.
Abstract (English)
Background: This study was conducted to assess the incidence of maternal lower genital tract injuries, study the various types of maternal lower genital tract injuries during vaginal delivery and to assess complications and morbidity due to lower genital tract injuries. Methods: This was a hospital-based prospective observational study conducted among 100 female patients admitted to the labour room for vaginal delivery in the Government General Hospital Kakinada, from December 2019 to October 2021 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: Majority of genital tract injuries occurred in the second gravida of about 69%, 1% of cases belong to the fifth gravida. 76% of cases are booked and 24% are unbooked. Among the women with co-morbidities, the frequency of genital tract injuries in preeclampsia was 10%. The frequency of genital tract injuries in GDM was 2%. The maximum number of genital tract injuries occurred in women with a normal duration of labour (78%). 62% of cases have a birth weight of 3.6-4 kg. 6% of cases have a birth weight of 2.5-3 kg. 60% of cases of genital tract injuries occurred during spontaneous delivery. 40% of cases of genital tract injuries occurred during outlet forceps delivery. 44% of cases were 2nd degree perineal tears. 2% of cases were cervical lacerations. Conclusion: Skilled birth attendants in labour, vigilant labour monitoring, identifying risk factors such as perineal injuries in previous deliveries, a big baby, a timely episiotomy, a proper Ritgen’s manoeuvre, timely and adequate suturing, the allocation of medical personnel depending on risk factors, the provision of emergency obstetric care services that are accessible and affordable, and perineal care in the postnatal period help a lot in reducing the rate of genital tract injuries and complications.
Files
IJPCR,Vol15,Issue7,Article28.pdf
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Additional details
Dates
- Accepted
-
2023-05-05
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue7,Article28.pdf
- Development Status
- Active
References
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