title: Nonobstetric lower genital tract injuries in rural India.
abstract: OBJECTIVE
  To study the impact of nonobstetric genital tract injury (NOGTI) in rural India.
  
  
  METHODS
  A prospective observational study of 52 consecutive women admitted with NOGTIs caused by voluntary coitus or accidental injury. Details of the causes of trauma, clinical presentations, and management were recorded.
  
  
  RESULTS
  A total of 17 women (32.7%) presented with coital trauma, while 35 women (67.3%) sustained noncoital injuries: bicycle/automobile accidents (10); fall from height (7); cattle horn injury (7); straddle-type trauma (6); leech bites (3); and vaginal foreign bodies (2). Most women had multiple injuries; 15 women developed vulvar hematomas and 3 had anorectal lacerations. Management included immediate resuscitation along with primary repair of injuries, evacuation of vulvar hematomas, and removal of vaginal foreign bodies. Fifteen women (28.8%) required blood transfusions; none of the women died.
  
  
  CONCLUSIONS
  Severe hemorrhage caused by NOGTIs is potentially fatal in rural settings if treatment is delayed. Prompt resuscitation, early referral, and appropriate surgical intervention can avert both morbidity and mortality.
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Postgraduate Medical Education and Research, Kolkata, India. njana1@vsnl.net
authors.forename: Narayan
authors.initials: N
authors.lastname: Jana
authors.forename: Debjyoti
authors.initials: D
authors.lastname: Santra
authors.forename: Debasis
authors.initials: D
authors.lastname: Das
authors.forename: Anindya K
authors.initials: AK
authors.lastname: Das
authors.forename: Subhendu
authors.initials: S
authors.lastname: Dasgupta
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003075:Coitus; D004632:Emergency Medical Services; D005260:Female; D005836:Genitalia, Female / Q000293:injuries*; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007194:India / Q000453:epidemiology; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D011446:Prospective Studies; D012424:Rural Population; D014621:Vagina / Q000293:injuries; D055815:Young Adult