Addisu Dagne, Fentahun Betelihem
College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
BSc Midwife, Felege Hiwot Comprehensive Referral Hospital, Bahir Dar, Amhara, Ethiopia.
SAGE Open Med. 2024 May 20;12:20503121241252956. doi: 10.1177/20503121241252956. eCollection 2024.
Birth-related perineal trauma is a public health issue that can lead to significant maternal morbidity in low-income countries like Ethiopia. Research on the proportion and underlying factors of birth-related severe perineal tears is rare, both in the study area and throughout Ethiopia. As a result, this study was intended to determine the proportion of birth-related severe perineal tears and associated factors at hospitals in Bahir Dar town, Ethiopia.
A cross-sectional study was undertaken at government hospitals in Bahir Dar, Ethiopia. Five hundred fifteen study subjects were selected using a systematic sampling technique. The data was collected through chart reviews and interviews. Data was entered and analyzed using SPSS Version 23. A binary logistic regression was employed to identify factors, and an adjusted odds ratio and a 95% CI were used to estimate the strength of relationships. Statistical significance was declared at -value < 0.05.
The prevalence of severe perineal tears was 7.4%. Previous history of a perineal tear (AOR = 3.06, 95% CI = 1.24-7.59), being nullipara (AOR = 4.03, 95% CI = 1.42-11.44), occipito-posterior position (AOR = 5.49, 95% CI = 2.27-13.28), duration of second stage of labor > 2 h (AOR = 5.42, 95% CI = 2.26-12.99), birth attendant's work experience <1 year (AOR = 5.98, 95% CI = 2.16-16.57) were found to be associated with birth-related severe perineal tear.
The proportion of birth-related severe perineal tears was high at governmental hospitals in Bahir Dar town. Previous history of perineal tear, work experience of birth attendants, duration of the second stage of labor, being nullipara, and occipito-posterior position were the major determinants of severe perineal tear. This study suggests that strategies and regulations should be developed to shorten the second stage of labor.
分娩相关的会阴创伤是一个公共卫生问题，在埃塞俄比亚等低收入国家可导致严重的孕产妇发病情况。在研究地区乃至整个埃塞俄比亚，关于分娩相关严重会阴撕裂的比例及潜在因素的研究都很少。因此，本研究旨在确定埃塞俄比亚巴赫达尔镇各医院分娩相关严重会阴撕裂的比例及相关因素。
在埃塞俄比亚巴赫达尔的政府医院开展了一项横断面研究。采用系统抽样技术选取了515名研究对象。通过病历审查和访谈收集数据。使用SPSS 23版软件录入并分析数据。采用二元逻辑回归确定相关因素，并使用调整后的比值比和95%置信区间来估计关联强度。当P值<0.05时判定具有统计学意义。
严重会阴撕裂的患病率为7.4%。会阴撕裂既往史（调整后的比值比=3.06，95%置信区间=1.24 - 7.59）、初产妇（调整后的比值比=4.03，95%置信区间=1.42 - 11.44）、枕后位（调整后的比值比=5.49，95%置信区间=2.27 - 13.28）、第二产程时长>2小时（调整后的比值比=5.42，95%置信区间=2.26 - 12.99）以及接生员工作经验<1年（调整后的比值比=5.98，95%置信区间=2.16 - 16.57）均被发现与分娩相关严重会阴撕裂有关。
在巴赫达尔镇的政府医院中，分娩相关严重会阴撕裂的比例较高。会阴撕裂既往史、接生员工作经验、第二产程时长、初产妇以及枕后位是严重会阴撕裂的主要决定因素。本研究表明应制定策略和规定以缩短第二产程。
