|The Pattern and Maternal Outcome of Lower Genital Tract Injuries Among Women With Vaginal Deliveries in Calabar; A Niger Delta State of Nigeria|
|Charles Njoku, Cajethan Emechebe, Christopher Iklaki, Felix Nnorom|
|Department of Obstetrics & Gynecology, University of Calabar Teaching Hospital (UCTH), Calabar, Cross River state, Nigeria|
IJWHR 2015; 3: 190?195
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Keywords : Cervix, Episiotomy, Genital tract, Obstetric delivery, Perineum, Vagina
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Objectives: ower genital tract injuries are associated with high maternal morbidity or mortality if severe, poorly managed or delayed in repair. It is a frequent complication of vaginal delivery. The aim of the present study was to determine the prevalence, demographic characteristics and pattern of spontaneous lower genital tract injuries and its relation to parity and place of delivery. Also, to determine the complications of lower genital tract injuries following vaginal delivery managed in UCTH, Calabar.
Materials and Methods: This was a retrospective study of women managed for lower genital tract injuries at UCTH from 1 January, 2009 to 31 December, 2014. All women who sustained spontaneous lower genital tract trauma following vaginal delivery were studied.
Results: Out of 15 526 total deliveries over the study period, 1413 women sustained lower genital tract injuries, giving a prevalence rate of 9.1%. The most frequent lower genital tract injuries include first degree perineal tear 40.2%, second degree perineal tear 18.3%, peri-urethral tear 14.5% and cervical laceration 11.9%. The prevalence of vaginal lacerations and third/fourth degree perineal tear were highest among primigravida, while cervical laceration was highest among primiparous. The most frequent morbidity observed were anemia (44.8%) and postpartum hemorrhage (31.6%). The maternal mortality of 0.68% was recorded and all were unbooked women who delivered outside UCTH.
Conclusion: The associated morbidity and mortality following lower genital tract injury in this study were high mostly among unbooked women who delivered outside the hospital. This can be reduced by health education, uptake of antenatal care and skilled attendance in labor.
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