Frequency of genital tract trauma in primigravida in Tertiary Care Hospital of Quetta.

Abstract

 Genital tract trauma is a common outcome of vaginal birth. These injuries can lead to serious complication like pain, dyspareunia, urinary and fecal incontinence, post-partum hemorrhage and fistulae. Objectives: To determine the frequency of genital tract trauma and its types, following spontaneous vertex delivery in primigravida. Study Design: Cross sectional study. Setting: Department of Obstetrics and Gynecology Unit 4, Bolan Medical Complex Hospital Quetta. Period: From 1^st September 2018 to 31^st March 2019. Material & Method: A total of 127 Primigravida with vertex presentation were randomly included in the study. Frequency and percentages were calculated for genital tract trauma, type of trauma and episiotomy. Results: Frequency of genital tract trauma was found in 40 patients (31%). Regarding the type of trauma 90% (36/40) had perineal tear and 10% (4/40) had cervical tear. First degree perineal tear was seen in 17(47%), 2nd degree perineal in 18(50%) and one case of 3rd degree perineal tear was seen. Episiotomy was given in 40(32%). Conclusion: It is difficult to reduce the frequency of genital tract trauma after vaginal birth in primigravida, however their avoidance, recognition and management should be crucial for obstetricians. Mediolateral episiotomy appears to be protective against perineal trauma but its use should be restricted.