Incidence and Determinants of Birth Canal Injuries After Vaginal Delivery at Wad Madani Hospital, Sudan

Nawal Mohammed Elagib

Abstract: Background: The female perineum, forming the diamond - shaped inferior outlet of the pelvis, is highly susceptible to trauma during labour. Spontaneous perineal tears and iatrogenic episiotomies can lead to both immediate and long - term maternal morbidity. Objective: To determine the incidence, patterns, risk factors, and outcomes of birth canal injuries following vaginal deliveries at Wad Madani Obstetrics and Gynaecology Teaching Hospital between January and June 2024. Methods: We conducted a prospective, cross - sectional, hospital - based study. All women who sustained birth canal injuries during vaginal delivery at Wad Madani Teaching Hospital over the six - month period were enrolled. Data were collected via a structured questionnaire administered after informed consent. Injury types, maternal and obstetric characteristics, management details, and complications were recorded and analyzed. Results: Of 5, 237 vaginal deliveries, 102 women (1.9%) experienced birth canal injuries. Injury distribution was: cervical tears 38 (37.3%), perineal tears 31 (30.4%), vaginal tears 23 (22.5%), extended episiotomies 5 (4.9%), mixed lacerations 4 (3.9%), and de - circumcision injuries 1 (1%). More than half (52.9%) of injured women developed complications, including heavy bleeding 51 (94.4%), infection 12 (22.2%), vulvar hematoma 3 (5.6%), laparotomy 2 (3.7%), hysterectomy 2 (3.7%), disseminated intravascular coagulation 2 (3.7%), and rectovaginal fistula 1 (1.9%). The maternal mortality ratio was 57 per 100, 000 live births. Significant risk factors included instrumental delivery 10 (9.8%), assisted breech delivery 5 (4.9%), prolonged second stage of labour 20 (19.6%), home delivery under traditional birth attendant supervision 7 (6.9%), unattended home delivery 4 (3.9%), primigravity 51 (50%), and birth weight >4, 000 g 14 (13.7%). Only 25.9% of midwives and 51.2% of doctors had received formal training in birth canal injury management. Conclusion: The rate of birth canal injuries at this centre is substantial. There is a critical need to improve training for both doctors and midwives in the anticipation, prevention, and prompt recognition of perineal and cervical trauma during vaginal delivery.

Keywords: Birth canal injuries, Vaginal delivery, Perineal tears, Cervical tears, Obstetric lacerations, Maternal morbidity, Risk factors

How to Cite?: Nawal Mohammed Elagib, "Incidence and Determinants of Birth Canal Injuries After Vaginal Delivery at Wad Madani Hospital, Sudan", Volume 14 Issue 6, June 2025, International Journal of Science and Research (IJSR), Pages: 912-915, https://www.ijsr.net/getabstract.php?paperid=SR25612112905, DOI: https://dx.doi.org/10.21275/SR25612112905