Anam Zulfiqar, Afshan Saeed, Shahana Rahat.
Genital Tract Trauma; Factors Responsible in Pregnant Females Undergoing Vaginal Delivery.
Professional Med J Jan ;25(4):573-6.

Aims and objectives: To record frequency of factors responsible for genital tract trauma in pregnant females undergoing vaginal delivery. Study Design: Descriptive cross sectional trial. Period: 18-11-2015 to 17-02-2016 (3 months). Settings: Holy Family Hospital, Rawalpindi. Material & methods: 100 cases with genital tract trauma during delivery (at hospital or referral) in the form of tears or laceration, which may be cervical, vaginal or perineal were included in the study. After third stage of labour, we examined vulva, vagina and cervix for presence of any tears/lacerations. The causative factors of lacerations/tears including mode of delivery (assisted/spontaneous) birth weight of the neonate (<4kg/>4kg), multiparous / primiparous and place of labour (referral/institutional) were recorded. Results: Mean age 28.88+3.41 years, cervical injury in 26% (n=26) cases, vaginal injury was present in 36% (n=36) and 38% (n=38) and findings of perineal injury. Risk factors causing genital tract trauma were recorded as 10%(n=10) had institutional place of labour while 90%(n=90) were delivered outside hospital through untrained health care providers, 24%(n=24) were primiparous while 76%(n=76) were multiparous, 69%(n=69) were delivered spontaneously, 31%(n=31) had assisted delivery, 67%(n=67) had >4kg fetal weight at birth while 33%(n=33) had <4kg weight of fetus at birth. Conclusion: Un-booked and birth outside hospital by unskilled health care workers was the significant risk factor responsible for genital tract trauma.

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