Prevalence and Risk Factors of Perineal Tears at the Limbe Regional Hospital, Cameroon

Background: Most of the studies on the prevalence and predisposing factors of perineal tears have been in developed countries. A few studies have been carried out in developing countries including Cameroon. The aim of this study is two fold: to 1) determine the prevalence and risk factors of perineal tear during vaginal delivery at the Limbe Regional Hospital, and 2) provide baseline data needed in auditing obstetric practice. Patients and Methods: This is a retrospective and prospective cross-sectional study. The retrospective data were obtained from the birth registers. Data was obtained for two consecutive years: 2011 and 2012, and included a total of 1336 birth records that were analysed to determine the prevalence and types of perineal tear and prevalence of episiotomies. The prospective study comprised a total of 200 women who gave birth at the LRH during the period January 21st through May 24th 2013. They were administered a structured questionnaire. The data for the prospective study was used to determine the predisposing factors of perineal tear. Data analysis was with Epi Info 7.0, and Microsoft Excel 2010 version. Statistical significance was set at P<0.05. Results: The average age of the participants was 25.8 (SD 5.0). The prevalence of perineal tear at the LRH was 19.2% and that of episiotomies was 2.3%. 13.1% of perineal tears were second-degree tears. Factors identified to be independently associated with perianal tears were: maternal age (25-40) (OR 2.6, 95% CI: 1.1-4.3;P=0.02), history of previous perineal tear (OR 3.4, 95% CI: 1.6-7.3;P<0.001), Antenatal care (ANC) visits (< 4) (OR 2.4, 95% CI: 1.26-4.53; P < 0.007), position of presenting part (occiputo-posterior) (OR 3.2, 95% CI: 1.6-6.12; P<0.001) and duration of second phase of labour (>30 minutes) (OR 3.2, 95% CI: 1.7-6.04; P<0.001). Conclusion: The prevalence of perineal tear was much higher than those of episiotomies in the LRH. Second-degree tears were more prevalent among the participants. Perineal outcomes at the LRH were excellent and should be maintained or improved.