A Case Control Study on the Risk Factors of Genital Tract Lacerations at Yaound� Central Hospital, Cameroon

Abstract

Genital tract lacerations are lesions resulting from breakage of continuity of the lower genital tract during birth. The objective of this study was to determine the risk factors for genital tract lacerations.  Once identified, women who had suffered genital tract lacerations were interviewed, after which they underwent physical examination aimed at identifying the laceration site and type. We paired these women to those of same age and parity who did not have genital tract laceration (control group). Data were collected using a questionnaire and analyzed with Epi info software version 3.5.1 with a significance level of P< 0.05. Out of 1250 deliveries, 150 women had genital tract laceration, giving the prevalence of 12%. But 14 has been excluded and retained 136 women as cases. Perineal tears accounted for 92.6% of genital tract lacerations, cervical tears 8.8% and vaginal tears 7.4%. Maternal risk factors were: past history of perineal tear (OR=5.05; 95% CI :1.9-13.7; p=0.00), length of the perineum < 4 cm (OR=33.72; 95% CI:17.2-66.02; p=0.00), duration of expulsion < 30 minutes (OR=3.16; 95%CI:1.9-5.2; p=0.00) and duration of active phase of labor < 6 hours (OR=5.01; 95% CI:2.8-8.9; p=0.00). Prior to delivery and in order to prevent trauma to the genital tract, the following risk factors should be sought out for: Past history of perineal tears, perineal lengths less than 4 cm, duration of the active phase of labour less than 6 hours, induction and augmentation of labor with newborn birthweights of more than 4000 g and expulsive phases lasting less than 30 minutes.  Also, care providers are advised to perform episiotomies in women presenting these risk factors.