Risk Factors for Perineal Tears Among Women Delivering at Kawempe National Referral Hospital, Uganda: A Case Control Study

Abstract

Background: Perineal tear is a common complication of vaginal delivery with a significant negative impact on the quality of life. The condition commonly occurs among un-attended deliveries or those conducted by unskilled birth attendant especially in low-resource settings. The risk factors for perineal tear were not known at Kawempe Hospital. We conducted this study to determine the risk factors for perineal tear among women delivering at Kawempe National Referral Hospital, Uganda. Methods: This was a case control study that was conducted among women who had vaginal delivery at Kawempe National Referral Hospital from 20th December 2019 to 5th February 2020. Data on sociodemographic, maternal, fetal and provider characteristics were collected using an interviewer’s administered questionnaire. Risk factors were determined using bivariate and multivariate logistic regression analysis. Results: The risk factors for perineal tear were: maternal age of ≥20 years (AOR=7.24, 95% CI=2.28- 23.00, P<0.001), delivery by assistant nursing officer (AOR=16.39, 95% CI=5.74-46.81, p <0.001), primiparity (AOR=12.46, 95% CI,=3.41-45.52, P<0.001), single marital status (AOR=14.39 95%, CI=4.28-48.39, P<0.001), precipitate labour (AOR=7.8, 95% CI=2.21-27.55, P< 0.001), assisted vaginal delivery (AOR= 8.33, 95% CI=1.43-48.6, P<0.019), fetal weight ≥ 3.5Kg (AOR=2.19, 95% CI= 1.06- 4.53, P<0.033), duration of active first stage of labour ≥8 hours (AOR=12.65, 95% CI=5.65-28.25, P<0.001) and duration of second stage of labour > 1hour (AOR=10.21 95% CI=3.32-31.41, P<0.001). Conclusions. The risk factors for perineal tear during vaginal delivery at Kawempe National Referral Hospital were: maternal age ≥ 20 years, delivery by assistant nursing officer, primiparity, single marital status, precipitate labour, assisted vaginal delivery, fetal weight ≥ 3.5kg, duration of active first stage of labour ≥8 hours, duration of second stage of labour≥1hours.

Prevalence of Maternal Fever and Associated Factors among Postnatal Women at Kawempe National Referral Hospital, Uganda: A Preliminary Study

“…The study was conducted from the 13th to the 30th of October 2022 in the postnatal ward of Kawempe National Referral Hospital (NRH) in the capital city, Kampala. Kawempe NRH is the busiest public maternity unit in the country, with 20,485 births in the financial year of 2022/2023, which translates to an average of 57 births daily [ 18 , 19 ]. From July 2022 through June 2023, there were 1103 stillbirths reported at Kawempe Hospital and 125 maternal deaths.…”