Abstract:
Perineal trauma is classified according to the degree of structures involved or according to the depth of the injury.
Mild perineal trauma is very common following vaginal delivery. Risk factors for perineal trauma include
primiparity, precipitate labour, instrumental deliveries, pushing techniques and birth positions. Perineal trauma is
associated with significant short-term and long-term complications. The objective of the study was to determine
the prevalence and risk factors for perineal trauma among women at teaching and referral hospital in western
Kenya. A cross-sectional study was carried out at the teaching hospital between April and May 2015. Two hundred
and nine women who had come to deliver at the facility were consented to participate in the study. A structured
checklist was used to obtain data from the women and make observations as skilled care givers attended to
deliveries. All analyses were performed at 95% level of confidence. Two hundred and nine (209) deliveries were
observed. Majority of the women, 76 (36.40%), were in the 20-24 age group. Ninety seven (46.10%) of them were
para 0. Eighty one (38.8%) of the women sustained various types of perineal trauma. Supine position during
delivery was the most preferred position, in 201 (96.2%), of the women. Age of the mother, parity, infant birth
weight, and history of previous trauma, were statistically significant, associated with trauma in the univariate
analysis (p=0.013; p=0.000; p= 0.010; p= 0.033) respectively. Adjusting for other factors, the odds of sustaining
perineal trauma increased with increased birth weight (OR 2.878; p= 0.005) and decreased with increasing parity
(OR 0.037; p=0.000). The prevalence of perineal tears as revealed by the study was 38.8%. This study
recommended evidence based practice during labour and delivery in order to improve pelvic floor outcomes as
well as reduce operative deliveries and long term morbidities.
