3rd Degree Tear of Perineum
A 3rd degree tear is a type of birth injury that involves the perineum and anal sphincter. The perineum is the bit of skin between the anus and the vaginal opening. The anal sphincter is the muscle that controls the anus.
Tear of perineum during birth
The perineum can tear during a vaginal or 'natural' birth. It happens because the vaginal opening cannot always stretch wide enough to allow the passing of the baby. Consequently the perineum rips.
The perineum may tear just a little bit, or the tear may be very deep. Because of the varying nature of perineal tears, medical practitioners have come up with a classification system that describes the injury and the structures involved.
There are four different types of perineal tear in this classification system: first degree tear, second degree tear, third degree tear and fourth degree tear. A first degree tear is the most minor, and a fourth degree tear is the most severe.
The different types of perineal tear affect different structures:
- A 1st degree tear only involves the skin of the perineum
- A 2nd degree tear involves both the skin and the muscle of the perineum
- A 3rd degree tear involves the skin and the muscle of the perineum, as well as the anal sphincter
- A 4th degree tear involves the skin and muscle of the perineum, the anal sphincter and the anal mucosa (the lining of the anus)
3rd degree tear repair
It is important that medical practitioners identify a perineal tear after the birth. It is also vital that the correct type of tear is diagnosed, because this will determine the type of treatment needed.
A 3rd degree tear requires a surgical repair in theatre. Dissolvable sutures are used to close the tear in the perineum and anal sphincter. A doctor who has been trained in obstetric anal repairs must conduct the procedure, as it is a complex repair. A midwife cannot repair a 3rd degree tear.
Because of the proximity to the anal sphincter, 3rd degree tears are at risk of infection. To prevent infection, a patient should be prescribed antibiotics. Other treatment is also useful, including laxatives to soften stools, and physiotherapy to strengthen the muscles.
3rd degree tear not repaired
The timing of a 3rd degree tear repair is also important. The repair must be done within 24 hours of the injury being sustained. Otherwise the tissues will disintegrate and the repair will not be as effective.
Unfortunately delays in 3rd degree tear repairs do happen. If you have been affected by a 3rd degree tear that was not repaired, or was poorly repaired, please get in touch with our team of solicitors. There could be a case of medical negligence.
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