Traumatic Cloaca After Vaginal Birth

If you have suffered a cloacal defect during the course of a vaginal delivery, you will understandably be feeling angry and upset about the devastating injury you have sustained. This will be especially true if the damage could have been prevented, or was not diagnosed and treated shortly after birth. If this has happened to you, you need to know what your options are.

Cloacal defect after childbirth

During a vaginal delivery, it is possible that a woman will suffer a tear to the perineum. The most acute perineal tear is called a fourth degree tear; this is an injury that involves the vaginal wall, perineum, anal sphincter, anal canal and rectum. In a few very rare cases the injury will be so extreme that the laceration will extend straight down from the vaginal opening to the rectum, leaving a woman with a gap between her vagina and anus. This type of injury is known as a traumatic cloaca.

Diagnosing and treating cloaca after vaginal delivery

After birth a doctor or midwife should perform a digital vaginal and rectal examination to ensure any perineal tears are detected. Evidently traumatic cloaca is an extensive defect and should be diagnosed during the post-partum examination. A woman should then be referred to a specialist obstetrician or colorectal surgeon who has the necessary skill and expertise to perform a repair in theatre.

Because cloaca is a very serious injury, surgery may not result in a woman regaining normal function. However, the sooner treatment is provided the better, as this will prevent the tissue from re-joining in the wrong position. A course of antibiotics should be administered to help avoid infection, while advice should also be given regarding wound hygiene. If these steps are taken it is possible that a woman will make a full recovery, meaning she is able to have sexual intercourse and is continent to both flatus and faeces.

Does traumatic cloaca amount to medical negligence?

If you have sustained a cloacal defect, you will of course be upset about the physical and emotional effects it has had on your life. It is likely you will also be wondering why this has happened to you. Sadly in some cases there is nothing that can be done to avoid such an injury and medical professionals can only diagnose and treat the defect as best they can. However, there are times when medical negligence causes the occurrence of traumatic cloaca, or causes the injury to deteriorate. For example, medical negligence will be at play if:-

The injury could have been prevented – eg. if there were known complications but an emergency Caesarean section was not performed;
The injury was assisted by medical error – eg. a negligent episiotomy;
The injury was not diagnosed soon after birth;
The injury was not repaired by a suitably qualified surgeon.

If you believe your cloacal defect was caused by any of the aforementioned factors, you need to contact a medical negligence solicitor as soon as possible, as you could be entitled to compensation.

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