Table 1 Clinical criteria for chronic obstetric morbidity [2, 15]
Sl.No | Morbidities | Symptoms | Signs |
|---|---|---|---|
1. | True Incontinence Obstetric Fistula ā¢ Vesico- vaginal Fistula ā¢ Rectro- vaginal Fistula | ā¢ Continuous leaking of urine (incontinence) ā¢ Foul/offensive odor of urine ā¢ Incontinence of liquid stool/flatus | ā¢ Vulval skin (redness, ulceration) ā¢ Palpation- Size,number,scarring ā¢ Speculum examination Fistula can be visualized ā¢ Speculum examination Fistula- exposing posterior vaginal wall ā¢ Rectal examination |
2. | Functional Incontinence Stress urinary incontinence (SUI). | ā¢ Involuntary loss of urine ā¢ Sneezing ā¢ Coughing | ā¢ Involuntary leakage from the urethra ā¢ Leakage showing with abdominal pressure, usually a sensation of urge ā¢ Incontinence due to contraction of the detrusor. |
3. | Pelvic inflammatory diseases | ā¢ Lower abdominal pain ā¢ Increased vaginal discharge ā¢ Menorrhagia ā¢ Low backache ā¢ Dysmenorrhoea | Per vaginal examination ā¢ Presence of abdominal/uterine tenderness ā¢ Cervical motion tenderness ā¢ Adnexal tenderness |
4. | Uterine prolapse | ā¢ Dragging discomfort ā¢ Something coming out from the vagina ā¢ Low backache ā¢ Vaginal discomfort ā¢ Vaginal discharge | Speculum Examination Patients asked to cough/bear down, decent of an anterior vaginal wall below its natural position, Decent of uterus below its natural position. |
5. | Urgent Incontinence Urinary tract infection | ā¢ Burning with urination ā¢ Increased frequency of urination ā¢ Pelvic pain | ā¢ Fever ā¢ Nausea ā¢ vomiting ā¢ Sepsis |