Ojule J D, Oriji V K, Georgewill K N
Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Niger J Med. 2012 Jan-Mar;21(1):36-40.
Morbidities associated with vagina deliveries are many but under reported. Where data exist, women had been shown to suffer myriad of problems following vaginal birth. These include immediate trauma to the perineum from episiotomy and perineal laceration at vaginal deliveries. These women may also have other problems such as pelvic pain, uterine descent and incontinence to urine, stool or flatus as well as sexual, social and psychological dysfunction on the long term. The objective of the study was to determine the prevalence and predisposing factors of perineal trauma amongst women delivering at the University of Port Harcourt Teaching Hospital.
A retrospective study of vaginal births between 1st January 2005 and 31st December 2007 at the University of Port Harcourt Teaching Hospital was done. The delivery register at the labour ward was used to identify the parturient with injury to the perineum following a vaginal birth. Data was retrieved from their case notes, entered into an excel spreadsheet and analyzed with SPSS version 17 for Microsoft windows.
A total of 2429 (53.8%) out of 54 parturient had trauma to their perineum at delivery. Episiotomies were in 1811 (40.1%) parturient and perineal tears occurred in 697 (13.7%) parturient. While the prevalence of episiotomy decreased with parity, the incidence of perineal tears was found to increase with parity. Assisted vaginal deliveries and high parity were risk factors for episiotomy and perineal tear respectively.
The perineal trauma prevalence rate of 53.8% in Port Harcourt is unacceptably highly. Nulliparity, vaginal breech and instrumental vaginal deliveries are the major risk factors for perineal trauma.
阴道分娩相关的发病率众多，但报告不足。在有数据的情况下，已表明女性在阴道分娩后会遭受诸多问题。这些问题包括阴道分娩时会阴切开术和会阴撕裂对会阴造成的直接创伤。这些女性长期来看还可能有其他问题，如盆腔疼痛、子宫脱垂以及尿失禁、大便失禁或排气失禁，还有性、社交和心理功能障碍。本研究的目的是确定哈科特港大学教学医院分娩的女性会阴创伤的患病率及诱发因素。
对2005年1月1日至2007年12月31日在哈科特港大学教学医院进行的阴道分娩进行回顾性研究。使用产房的分娩登记册来确定阴道分娩后会阴受伤的产妇。从她们的病历中检索数据，录入Excel电子表格，并使用适用于Microsoft Windows的SPSS 17版进行分析。
5400名产妇中共有2429名（53.8%）在分娩时会阴受到创伤。1811名（40.1%）产妇进行了会阴切开术，697名（13.7%）产妇发生了会阴撕裂。虽然会阴切开术的患病率随产次增加而降低，但会阴撕裂的发生率随产次增加而升高。辅助阴道分娩和高胎次分别是会阴切开术和会阴撕裂的危险因素。
哈科特港会阴创伤患病率53.8%高得令人无法接受。初产、阴道臀位分娩和器械助产阴道分娩是会阴创伤的主要危险因素。
