Firdisa Gamachis, Tilahun Temesgen, Kejela Gemechu
Department of Nursing, College of Medicine and Health Sciences, Mettu University, Mettu, Ethiopia.
Department of Gynecology and Obstetrics, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
Int Urogynecol J. 2022 Feb;33(2):421-429. doi: 10.1007/s00192-021-04883-y. Epub 2021 Jun 17.
Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women's health and productivity. Thus, it is very important to identify determinant factors and take preventive actions.
A hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town from May 1 to July 30, 2019. Cases were women with grade II, III and IV uterovaginal prolapse while controls were women free from uterovaginal prolapse but with other gynecologic diseases. Data were collected using pretested interviewer-administered questionnaires, and measurements on height and weight were taken to calculate the women's body mass index. Data were entered using Epi Data version 3.1, and analysis was carried out by SPSS version 20. Descriptive, bivariate and multivariable logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used, and statistical significance was declared at p < 0.05.
This study revealed age ≥ 40 years (AOR = 10.49; 95% CI: 4.03, 27.35), duration of labor ≥ 24 h (AOR = 8.32; 95% CI: 3.58, 19.33), instrumental delivery (AOR = 7.40; 95% CI: 1.21, 45.28), non- utilization of family planning (AOR = 3.14; 95% CI: 1.32, 7.47) and underweight (BMI < 18.5 kg/m) (AOR = 5.30; 95% CI: 1.83, 15.33) were determinants of uterovaginal prolapse.
Age ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning and underweight were identified as determinant factors of uterovaginal prolapse. Thus, family planning service utilization and appropriate and timely obstetric care are advisable.
子宫阴道脱垂在埃塞俄比亚等发展中国家是一个重大的公共卫生问题，这些国家的医疗保健服务有限。它严重影响妇女的健康和生产力。因此，识别决定因素并采取预防措施非常重要。
2019年5月1日至7月30日，在 Nekemte 镇的妇科门诊对86例病例和258例对照进行了一项基于医院的非匹配病例对照研究。病例为患有II级、III级和IV级子宫阴道脱垂的女性，而对照为无子宫阴道脱垂但患有其他妇科疾病的女性。使用预先测试的访谈式问卷收集数据，并测量身高和体重以计算女性的体重指数。数据使用 Epi Data 3.1版本录入，分析使用SPSS 20版本进行。进行了描述性、双变量和多变量逻辑回归分析。使用调整后的比值比和95%置信区间，p < 0.05时具有统计学意义。
本研究显示年龄≥40岁（调整后的比值比[AOR]=10.49；95%置信区间：4.03，27.35）、产程≥24小时（AOR=8.32；95%置信区间：3.58，19.33）、器械助产（AOR=7.40；95%置信区间：1.21，45.28）、未使用计划生育（AOR=3.14；95%置信区间：1.32，7.47）和体重过轻（体重指数<18.5kg/m²）（AOR=5.30；95%置信区间：1.83，15.33）是子宫阴道脱垂的决定因素。
年龄≥40岁、产程延长、器械助产、未使用计划生育和体重过轻被确定为子宫阴道脱垂的决定因素。因此，建议使用计划生育服务以及提供适当及时的产科护理。
