tear of the perineum


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tear of the perineum

Laceration of the perineum during delivery. There are four degrees of severity caused by overstretching of the vagina and perineum during delivery. Fetal malposition increases the chance of tears occurring.

A first-degree tear involves superficial tissues of the perineum and vaginal mucosa but does not injure muscular tissue. A second-degree tear involves those tissues included in a first-degree tear and the muscles of the perineum but not the muscles of the anal sphincter. A third-degree tear involves all of the tissues of the second-degree tear and the muscles of the anal sphincter. A fourth-degree tear extends completely through the perineal skin, vaginal mucosa, perineal body, anal sphincter muscles, and the rectal mucosa.

Complications include hemorrhage, infection, cystocele, rectocele, descent of uterus, and occasionally loss of bowel control. Surgery is necessary to treat this condition.

See also: tear