Obstetrical trauma to the genital tract following vaginal delivery.

OBJECTIVE

To determine the frequency, types and complications of genital tract trauma during child birth.

STUDY DESIGN

Case series.

PLACE AND DURATION OF STUDY

Department of Obstetrics and Gynaecology, Unit I, Liaquat University of Medical and Health Sciences, Jamshoro, from June 2006 to May 2010.

METHODOLOGY

All women who sustained genital tract trauma during delivery at the study centre and those referred from periphery with the same condition within 40 days of delivery were enrolled in the study. Exclusion criteria were women who sustained genital tract injury with caesarean section and genital tract trauma due to accident. Studied variables included age of women, parity, place of labour, type of trauma received and its immediate complications. The data was expressed in terms of descriptive statistics.

RESULTS

Out of a total 9216 cases admitted in maternity ward during the study period, 467 cases (5.06%) had sustained genital tract trauma. The most frequent obstetrical trauma seen in primiparous referral cases were vaginal tears in 16 cases (25.39%) and perineal tears in 12 cases (19.04%). Multiparous women were 196 (41.97%) and cervical tears were the most frequent obstetrical trauma in them (n=52, 26.53%). Grand multiparous women were 208 having cervical tears (44.4%) and uterine rupture in 77 cases (37.01%) each. Most frequent early morbidities were postpartum haemorrhage (n= 352, 75.37%), hypovolemic shock (n= 220, 47.10%) and infection (n=158, 33.83%). The mortality rate was 16.05%.

CONCLUSION

Genital tract trauma is a common complication of vaginal birth mostly seen in grand multipara, leading to haemorrhage, shock and infection.