Lower Genital Tract Injuries during Multiparous Vaginal Delivery in Tertiary Hospital of Western India: An Observational Study

Background: Maternal expulsive force with direct compression from the fetal head exerts downward force on the pelvic floor during childbirth during childbirth; the pelvic floor is exposed to direct compression from the fetal head and to downward pressure from maternal expulsive efforts. These create alterations in the muscles nerves and connective tissue. As parity increases cumulative effect gives rise to various long-term and short complications. Materials and methods: This present observational study is planned to evaluate the lower genital tract injuries following vaginal delivery with regard to their frequencies, types, severity, and complications. Most of the studies are conducted in primiparas. This study would be conducted in multiparas sustaining lower genital tract injuries; it may help to evolve the checklist of do’s and don’ts. Results: Out of 144 patients studied, 68.7% of patients had previous delivery. Out of which 51.4% had maximum injuries if compared to those with 2 or more injuries. Women with basal metabolic index (BMI) in the overweight and obese categories were more susceptible to lacerations with 2.6 and 1.98 odds ratio respectively. Induction and oxytocin also affect lower genital tract injuries causing a significant increase in their numbers whereas episiotomies have no significant change in lower genital tract injuries. Conclusion: This study would give insight into various factors such as parity, labor induction, prolonged labor, precipitate labor, injudicious use of oxytocin, improper technique of episiotomy, assisted vaginal delivery, and instrumental delivery affecting the lower genital tract.