Obstetrical trauma to the genital tract following vaginal delivery.
OBJECTIVE
To determine the frequency, types and complications of genital tract trauma during child birth.


METHODS
Case series.


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


METHODS
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%.


CONCLUSIONS
Genital tract trauma is a common complication of vaginal birth mostly seen in grand multipara, leading to haemorrhage, shock and infection.
Department of Obstetrics and Gynaecology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan. khaskhelimn@yahoo.com
Meharunnissa
M
Khaskheli
Shahla
S
Baloch
Aneela Sheeba
AS
Baloch
D000328:Adult; D002584:Cervix Uteri / Q000293:injuries*; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005836:Genitalia, Female / Q000293:injuries; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000453:epidemiology; D010298:Parity; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012771:Shock, Hemorrhagic / Q000175:diagnosis / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D014597:Uterine Rupture / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult