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lacerations or i ncisions which occur r ed at the t ime of
del i very ; ov e r 80% were i nfected e pisi otomy wounds. About hal f
( 47 . 5%) o f t he episiotomy wounds reviewed wer e infected an d
g ap ed.
The presence o f LGTI was also found t o be statisti cally
assoc i a t e d with the presence of UCT! i n aubj e ct.s (p "'O.O J ) . Th e
proportion of eubjecee with septic perineal l es i ons among
those with UGT! was almost twice (25 .8 \ ) that o f those with no
UCTI ( 1 4.0%) . When we a l so con s i d e r t h e patho ge nesis o f thes e
t wo t ype s o f infecti on, and the fa ct t hat many c au s ative
pathogens of UGTI a r e also a ssociated with \o,'OUOO i n f ec t i on , it
is likely t he tw o infections have s imilar pathogenic ori g ins .
The evidence from s t udies of pregnant women i n other
pa r t s o f the African cont inent (54 -5 6). i ndicate that ma ny
wome n in the region enter l a bou r with already i n fected genital
tracts . The outcomes of l a bour , s uch as t he t-eau l t i nq
s us c e pt i b l e placenta bed and the presence of a perinea l wound,
therefore facilitate the development of flo rid in f ection .
Together thes e factors may explain why UGTI a nd LGTI oc curred
together i n the s tudy SUbjects.
Rates o f LGT! found i n this study are at least two to t en
times higher than those reported i n deve lope d countries
[ 30 , 125 ). The women i n Kumasi therefore ha ve a problem of much
greater mag nit ud e . Al t hough no SUbjec t i n this s tUdy was f ound
to ha ve extensive or ve ry complicated LGTI the high infection