Scribd Logo
Upload

Welcome to Scribd!

  • 54 views

    Perineal Lacteration PDF

    Uploaded by

    Jocel Mae Aguillon Sumagang
    First, second, third, and fourth-degree perineal tears can occur during childbirth. First and second-degree tears involve the skin and muscles and usually heal within weeks with or without stitches. Third-degree tears extend into the anal sphincter muscle and may require operating room repair and take longer to heal, with potential for fecal incontinence. Fourth-degree tears extend through the anal sphincter into the rectum and require specialized operating room repair, with longer healing times and potential complications. An episiotomy is a surgical incision made to enlarge the vaginal opening, and can be midline or mediolateral.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Perineal Lacteration PDF

    Uploaded by

    Jocel Mae Aguillon Sumagang
    54 views4 pages
    First, second, third, and fourth-degree perineal tears can occur during childbirth. First and second-degree tears involve the skin and muscles and usually heal within weeks with or without stitches. Third-degree tears extend into the anal sphincter muscle and may require operating room repair and take longer to heal, with potential for fecal incontinence. Fourth-degree tears extend through the anal sphincter into the rectum and require specialized operating room repair, with longer healing times and potential complications. An episiotomy is a surgical incision made to enlarge the vaginal opening, and can be midline or mediolateral.

    Original Title

    PERINEAL LACTERATION.pdf

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    First, second, third, and fourth-degree perineal tears can occur during childbirth. First and second-degree tears involve the skin and muscles and usually heal within weeks with or without stitches. Third-degree tears extend into the anal sphincter muscle and may require operating room repair and take longer to heal, with potential for fecal incontinence. Fourth-degree tears extend through the anal sphincter into the rectum and require specialized operating room repair, with longer healing times and potential complications. An episiotomy is a surgical incision made to enlarge the vaginal opening, and can be midline or mediolateral.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    54 views4 pages

    Perineal Lacteration PDF

    Uploaded by

    Jocel Mae Aguillon Sumagang
    First, second, third, and fourth-degree perineal tears can occur during childbirth. First and second-degree tears involve the skin and muscles and usually heal within weeks with or without stitches. Third-degree tears extend into the anal sphincter muscle and may require operating room repair and take longer to heal, with potential for fecal incontinence. Fourth-degree tears extend through the anal sphincter into the rectum and require specialized operating room repair, with longer healing times and potential complications. An episiotomy is a surgical incision made to enlarge the vaginal opening, and can be midline or mediolateral.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 4

    Perineal tear - vaginal tear / perineal laceration

    - a tear in the tissue (skin and muscles) around the vagina and perineum
    - a tear in the perineum after spontaneous vaginal delivery
    - can involve the vagina, the labia, the cervix, and the area between the vagina and the rectum.
    - Many tears will heal without treatment, but severe tears can cause prolonged pain, problems
    with sex, and embarrassment.

    Perineal area - perineum


    - the space between the vaginal opening and anus

    During delivery the perineum can tear causing different degrees of vulvovaginal lacerations:
     superficial (first-degree tear), or
     deeper, affecting the muscle tissue (second-degree tear, equivalent to an episiotomy).

    Two adjacent tissues may also be damaged:


    1. The anal sphincter muscle
    - which is red and fleshy. A tear in this sphincter can be recognized by the loss of the anus'
    radial appearance (third-degree tear).

    - Repair of the muscle is essential to prevent faecal incontinence.

    2. The rectal mucosa


    - which is smooth and whitish, extending from the anus.

    - A tear in rectal mucosa (fourth-degree tear) must be sutured to prevent anal fistula with
    incontinence and infection.

    Reasons/causes of perineal laceration:


     a very quick delivery - the skin hasn’t had time to stretch and thin
     If it’s your first delivery.
     The position of the baby (face-up deliveries).
     Use of forceps or a vacuum during delivery.
     A large baby (more than 8 pounds).
     If you’ve had an episiotomy.
    1st-degree vaginal tear

    First-degree tears -are the least severe, involving only the perineal skin — the skin between the
    vaginal opening and the rectum and the tissue directly beneath the skin.
    - patient might experience some mild pain or stinging during urination.
    - These tears might or might not require stitches and typically heal within a few weeks
    - some mild pain or stinging when you pee

    - may not require stitches, although some do. They generally heal within a few weeks.

    2nd-degree vaginal tear


    Second-degree tears - involve the skin and muscle of the perineum and might extend deep into the vagina.
    - typically require stitches and heal within a few weeks.
    - usually requires stitches and will generally heal within a few weeks.

    - most common
    3rd-degree vaginal tear
    Third-degree tears - extend into the muscle that surrounds the anus (anal sphincter).
    - These tears sometimes require repair with anesthesia in an operating room
    rather than the delivery room and might take longer than a few weeks to heal.
    - Complications such as stool leakage (fecal incontinence) and painful intercourse are
    possible. If these problems occur, talk to your health care provider.
    - may need anesthesia and have it repaired in the operating room

    - may take longer than a few weeks to heal

    - may have complications such as leaking stool and painful intercourse.

    4th-degree vaginal tear


    Fourth-degree vaginal tears - are the most severe.
    - They extend through the anal sphincter and into the mucous membrane that
    lines the rectum (rectal mucosa).
    - Fourth-degree tears usually require repair with anesthesia in an operating
    room rather than the delivery room and sometimes require more specialized
    repair.
    - Healing also might take longer than a few weeks.
    - need to be repaired in the operating room with anesthesia
    - need a more specialized type of repair
    - Healing may take longer than a few weeks
    - may have complications such as leaking stool and painful intercourse.
    Episiotomy -is a cut (incision) through the area between your vaginal opening and your anus. This area is
    called the perineum. This procedure is done to make your vaginal opening larger for childbirth.

    - a surgical incision intentionally to increase the diameter of the vulval outlet to facilitate
    delivery.

    Episiotomy Types

    1. Mediolateral episiotomy
    - the preferred method in other parts of the world. Both types have various advantages and
    disadvantages.

    1. Midline Episiotomy
    - the incision is made in the middle of the vaginal opening, straight down toward the anus.

    - advantages of a midline episiotomy include :


     easy repair and improved healing
     less painful
     is less likely to result in long-term tenderness or problems with pain during sexual
    intercourse
     often less blood loss

    - main disadvantage of a midline episiotomy is the increased risk for tears that extend into or
    through the anal muscles. This type of injury can result in long-term problems, including fecal
    incontinence, or the inability to control bowel movements.

    1. Mediolateral episiotomy
    - the preferred method in other parts of the world. Both types have various advantages and
    disadvantages.

    - the incision begins in the middle of the vaginal opening and extends down toward the
    buttocks at a 45-degree angle.

    - primary advantage of a mediolateral episiotomy is that the risk for anal muscle tears is much
    lower

    - disadvantages associated with this type of episiotomy, including:


     increased blood loss
     more severe pain
     difficult repair
     higher risk of long-term discomfort, especially during sexual intercourse

    You might also like