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Dissertation Chapters | Obstetrics and Gynecology | Tanzania | Volume 13 Issue 6, June 2024 | Rating: 5.1 / 10
Prevalence and Risk Factors for Perineal Tears in Women Delivering in Regional Hospitals in Dar-Es-Salaam from May to June 2019
Neema L Ntamanwa
Abstract: Background: In African countries, prevalence of perineal tear in Nigeria and South Africa was 53.8% and 16.2% respectively. Perineal tears contribute to Post Partum Hemorrhage which contributes to 39% of maternal deaths in Tanzania. Risk factors for perineal tears found in other studies were ethnicity, birth weight over 4 kg, nulliparity, shoulder dystocia, assisted vaginal delivery, episiotomy, maternal pushing position, longer duration of second stage, younger than 25 years, GA >40wks, prolonged labour, head circumference 34cm< at birth, fundal pressure, previous perineal tear, lack of manual perineal protection, deficient visualization of perineum, perineal oedema and use of oxytocin. Major shifts, in obstetric practice have been adopted, including alternative birth positions and manual perineal protection. However, despite the adoption of those strategies, occurrence of pereneal tears remains significant. Objective: To determine Prevalence and risk factors for perineal tears in women delivering in regional hospitals in Dar-es -salaam from May to June 2019. Study Design: Descriptive cross-sectional study was conducted. Study area: Mwananyala, Amana, And Temeke Regional Referral Hospitals in Dar es salaam. Study Population: women delivering in the labour wards of the three selected regional hospitals in Dar-es-salaam from May to June 2019. Data collection and analysis: all delivering women in the labour wards of selected regional hospitals who met inclusion criteria were recruited in the study, structured questionnaires were filled, perineal examination was done in delivering women before delivery in order to see whether there was presence of scars and oedema. Perineal examination was also done after delivery in order to see whether the post delivery woman had attained perineal tears. Prevalence of perineal tear was obtained. A total of 394delivering women in these selected regional hospitals were analyzed. Results: Prevalence of perineal tear was 53% among women delivering in the selected regional hospitals in Dar es salaam. Women who were carrying fetus with gestation age of over 40 weeks and head circumference 34 cm and above were more likely to develop perineal tears. Not performing examination of perineum also increased the risk of occurrence of perineal tear. Perineal pain occurred 62.2% in women who had perineal tears, and Post Partum Hemorrhage occurred in 4.8% in women who had perineal tears. Conclusion: Perineal tear is a significant problem due to its prevalence of 53% found in our study. Risk factors associated with occurrence of perineal tears were gestation age above 40 weeks, head circumference 34cm and above, and lack of examination of perineum. Some of the risk factors found in this study were similar to those found in other countries.
Keywords: Post Partum Hemorrhage, Gestation age, External anal sphincter, Internal anal sphincter, Obstetrics Anal Sphincter Injuries
Edition: Volume 13 Issue 6, June 2024,
Pages: 95 - 108