Frequency and severity of perineal tears in Countess Lady Duffrin Fund Hospital, Hyderabad.

OBJECTIVE To observe the frequency and severity of perineal tears during vaginal delivery. METHODS It was a prospective observational study done at the Countess Lady Duffrin Fund Hospital, Hyderabad, Pakistan, from December 1, 2009 to May 31, 2010. Women with full-term singleton pregnancy primigravida or multigravida, in active labour were included in the study. Patients with pre-term labour, breech presentation and antepartum haemorrhage were excluded, leaving the study population to be 147/1488. A predesigned structured proforma was used after informed verbal consent by the patient. All results were analysed on SPSS version 11. Frequencies and percentages were calculated, while Spearman's rho test (two-tailed) was applied for categorical variables. A p-value of less than or equal to 0.05 was considered significant. RESULTS The frequency of perineal tears in our study was 147/1488 (9.8%). The mean age was 28.08 +/- 7.47, ranging between 17-42 years. The vast majority, 100 (68%) delivered spontaneously, 45 (30.6%) were delivered with help of the forceps, and only 2 (1.4%) had vacuum delivery. Parity, oxytocin use, mediolateral episiotomy, forceps use, weight of babies > 3.6 kg were significantly associated with perineal tears. CONCLUSION Perineal tears cause considerable post-natal morbidity. Identification of risk factors, vigilant monitoring during labour and good perineal support is recommended for minimising the risk of perineal trauma as well as morbidity.