PREVALENCE AND ASSOCIATED FACTORS OF MATERNAL BIRTH TRAUMA DURING VAGINAL DELIVERY AT UNIVERSITY OF GONDAR COMPREHENSIVE SPECIALIZED HOSPITAL, NORTH-WEST ETHIOPIA, 2022

Abstract

ABSTRACT Background: Maternal injury with any form of perineal trauma following vaginal delivery is very common which ranges globally from 16.2% to 90.4%. The frequency of Obstetric anal sphincter Injuries (OASIs) range from 0.1% to 25% and the incidence of cervical laceration ranges from 0.2% to 1.1%. However, in Ethiopia, there is limited evidence on the prevalence of maternal birth trauma and its determinant factors after vaginal delivery. Objective: To assess the magnitude and associated factors of Maternal Birth Trauma during vaginal delivery at University of Gondar Comprehensive Specialized Hospital, Gondar, NorthWest Ethiopia, 2022. Methods: An Institution based cross-sectional study was conducted among mothers with singleton vaginal delivery at UoGCSH from 9 th May to 9 th August 2022 in 424 study participants selected using simple random sampling. Pre-tested semi-structured questioner was utilized. Epi-Data version 4.6.0.0 was used for data entry and exported to SPSS version 25 for data management and analysis. Chi square assumption was checked to assess variables eligibility for logistic regression. To identify the determinant factors, binary logistic regression model was fitted and variables with p-value<0.2 were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, Variables with Pvalue<0.05 were considered to have statistical significant association with the outcome variable. The Adjusted Odds Ratio (AOR) with 95% CI was reported to declare the statistical significance and strength of association between Maternal Birth Trauma and independent variables. Results: A total of 424 mothers who delivered vaginally were included. The mean age of participants was 26.83 years (� 5.220 years). The proportion of birth trauma among mothers after vaginal delivery was 47.4% (95%CI: 43.1, 51.7). Of different forms of perineal trauma, First degree tear in 42.8%, OASIs in 1.5% and Cervical laceration in 2.5% study participants. In the multivariable binary logistic regression analysis being primiparous (AOR=3.00; 95%CI: 1.68, 5.38), Gestational age ?39 weeks at delivery (AOR=2.96; 95%CI: 1.57, 5.57), heavier birth weight (AOR=33.34; 95CI: 12.27, 90.61), bigger head circumference (AOR=5.45; 95%CI: 2.62, 11.31), operative vaginal delivery (AOR=6.59; 95%CI: 1.44, 30.03) and delivery without perineum and/or fetal head support (AOR=6.30; 95%CI: 2.21, 17.94) were significantly associated with the presence of maternal birth trauma. Conclusion and recommendation: Among mothers who had vaginal delivery, the magnitude of maternal birth trauma during delivery was high. Prim parity, gestational age beyond 39 weeks at delivery, heavier birth weight, bigger head circumference, operative vaginal delivery and delivery without perineum and/or fetal head supported were factors affecting perineal outcome. The MoH of Ethiopia should provide regular interventional training as to reduce maternal birth trauma Keywords: Vaginal delivery, perineal trauma, cervical laceration, OASIs, Crossectional study, Ethiopia