Prevalence and characteristics of accidental perineal tears during childbirth in a communal medical center in Guinea-Conakry: a cross-sectional study


  • Oumou Hawa Bah Department of Gynaecology and Obstetrics, Gamal Abdel Nasser University of Conakry, Guinee
  • Boubacar Alpha Diallo Department of Gynaecology and Obstetrics, Gamal Abdel Nasser University of Conakry, Guinee
  • Aboubacar Fode Momo Soumah Department of Gynaecology and Obstetrics, Gamal Abdel Nasser University of Conakry, Guinee
  • Boubacar Siddi Diallo Department of Gynaecology and Obstetrics, Gamal Abdel Nasser University of Conakry, Guinee



Delivery, Perineum, Prognosis, Traumatism


Background: Prevalence studies are still rare in sub-Saharan Africa on perineal tears. We conducted this cross-sectional study in a communal hospital in Guinea-Conakry, with the objective of this study was to determining the prevalence and characteristics of post-obstetric perineal lesions.

Methods: All deliveries between March 1st and August 31st, 2014 were reviewed. We included in the analysis all the single deliveries with perineal tears. The Anglo-Saxon classification of perineal tears was used.

Results: The prevalence of perineal tears was 5.7% with 5.4% benign lesions and 0.3% severe lesions. We did not register 4th degree lesions. The average age of parturient was 22 years. The majority (96.6%) of parturient had a history of genital mutilation and perineal scarring (60.3%).

Conclusions: This prevalence appear low compared to those reported in other studies in Africa and point to the need for more sophisticated studies to have a better estimate of the prevalence of perineal tears in Guinea-Conakry.


Harvey MA, Pierce M, Walter JE, Chou Q, Diamond P, Epp A, et al. Obstetrical anal sphincter injuries (OASIS): prevention, recognition, and repair. J Obstet Gynaecol Canada. 2015;37(12):1131-48.

Barbier A, Poujade O, Fay R, Thiébaugeorges O, Levardon M, Deval B. Is primiparity the only risk factor for lesions of the anal sphincter during childbirth? Obstet Fertii Gynecol. 2007;35(2):101-6.

Pizzoferrato AC, Samie M, Rousseau A, Rozenberg P, Fauconnier A, Bader G. Severe post-obstetric perineal tears: Medium-term consequences on women's quality of life. Prog Urol J Association Francaise. 2015;25(9):530-5.

Villot A, Deffieux X, Demoulin G, Rivain AL, Trichot C, Thubert T. Management of complete perineums (stage 3 and 4 perineal tear): literature review. La Revue Sage-Femme. 2016;15(1):10-8.

De Rham M, Meyer S, Achtari C, Fornage S. Long term consequences of obstetrical anal sphincter injuries on sexual function. Revue Med Sci. 2017;13(554):602-6.

Fenner DE, Genberg B, Brahma P, Marek L, DeLancey JO. Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol. 2003;189(6):1543-9.

Joris F, Hoesli I, Kind A, Ries JJ, Kavvadias T. Obstetrical and epidemiological factors influence the severity of anal incontinence after obstetric anal sphincter injury. BMC Preg Childbirth. 2019;19(1):94.

Mous M, Muller S, De Leeuw J. Long-term effects of anal sphincter rupture during vaginal delivery: faecal incontinence and sexual complaints. Int J Obstet Gynaecol. 2008;115(2):234-8.

Nygaard IE, Rao SS, Dawson JD. Anal incontinence after anal sphincter disruption: a 30-year retrospective cohort study. Obstet Gynecol. 1997;89(6):896-901.

Pollack J, Nordenstam J, Brismar S, Lopez A, Altman D, Zetterstrom J. Anal incontinence after vaginal delivery: a five-year prospective cohort study. Obstet Gynecol. 2004;104(6):1397-402.

Callewaert MG, Albersen K, Janssen MS, Damaser T, Van Mieghem CH, van der Vaart J. Deprest: The impact of vaginal delivery on pelvic floor function – delivery as a time point for secondary prevention, Int J Obstet Gynecol. 2016;123:678-81.

Ray CL, Audibert F, Cabrol D, Goffinet F. Obstetrics: A Comparative Study "Here-Elsewhere" Canada-Franc. J Obstet Gynaecol Canada. 2009;31(11):1035.

Faltin DL, Boulvain M, Floris LA, Irion O. Diagnosis of anal sphincter tears to prevent fecal incontinence: a randomized controlled trial. Obstet Gynecol. 2005;106(1):6-13.

Nichols CM, Nam M, Ramakrishnan V, Lamb EH, Currie N. Anal sphincter defects and bowel symptoms in women with and without recognized anal sphincter trauma. Am J Obstet Gynecol. 2006;194(5):1450-4.

Dudding TC, Vaizey CJ, Kamm MA. Obstetric anal sphincter injury: incidence, risk factors, and management. Ann Surg. 2008;247(2):224-37.

Egbe TO, Kadzem LN, Takang WA, Tchounzou R, Egbe EN, Mbu RE. Prevalence and risk factors of perineal tears at the limbe regional hospital, cameroon. Int J Reprod Fertil Sex Health. 2016;3(3):70-8.

Fouedjio JH, Madi MTJ, Fouelifack YF, Fouogue TJ, Essiben F, Nana NP, et al. Factors associated with perineal tear at the maternity of the Yaounde Central Hospital, Cameroon. Health Sci Dis. 2015;16:4.

Fouelifack FY, Eko FE, Ko AC, Fouedjio JH, Mbu RE. Treatment of perineal wounds during the post partum period: evaluation of whether or not antibiotic should be systematically prescribed. Pan Afr Med J. 2017;28:144.

Fouelifack FY, Tameh TY, Mbong EN, Nana PN, Fouedjio JH, Fouogue JT, et al. Outcome of deliveries among adolescent girls at the Yaoundé central hospital. BMC Preg Childbirth. 2014;14(1):102.

Cisse CT, Niang M, Abdallah K, Faye EO. Perineal damage during childbirth. Af J Surg. 2014;3(2):94-101.

Gandzien PC. Obstetric perineal tears at the Talangaï-Brazzaville Base Hospital. Black African Med. 2005;52(10):565-6.

Andrews V, Sultan AH, Thakar R, Jones PW. Risk factors for obstetric anal sphincter injury: a prospective study. Birth. 2006;33(2):117-22.

Faltin DL, Otero M, Petignat P, Sangalli MR, Floris LA, Boulvain M, et al. Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence. Am J Obstet Gynecol. 2006;194(5):1255-9.

Laine K, Skjeldestad FE, Sanda B, Horne H, Spydslaug A, Staff AC. Prevalence and risk factors for anal incontinence after obstetric anal sphincter rupture. Acta Obstet Gynecol Scand. 2011;90(4):319-24.

Millogo-Traore F, Kaba ST, Thieba B, Akotionga M, Lankoande J. Maternal and foetal prognostic in excised women delivery. J Gynecol Obstet Repro Biol. 2007;36(4):393-8.






Original Research Articles