Perineal trauma in Port Harcourt, Souh-south Nigeria

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.