perineal tear
Post on 12-Apr-2015
29 Views
Preview:
DESCRIPTION
TRANSCRIPT
“Episiotomy compared with those after spontaneous perineal laceration ,..We found a significantly higher infection rate and a longer healing period in the episiotomy group”… “The results indicate that many women will unnecessarily suffer after an episiotomy”
(Department of Obstetrics and Gynecology, Central Hospital,Skövde, Sweden)
A first-degree laceration or superficial tear
often so small that few or no stitches are required. (but surgical repair will help in early healing and maintain the proper anatomy of the vagina)
heal spontaneously (w/in few weeks)
cause little or no discomfort.
Second degree laceration Involves rupture of the
muscles of the perineum with deep tears in the vaginal wall
Should be immediately repaired (stiches), preferably as soon as the baby and the placenta has been delivered, or at least within the first 24 hours
It will cause some discomfort take a few weeks to heal
The stitches dissolve on their own during the healing period
Third degree laceration Extends from the vaginal opening
through the posterior vaginal wall and the perineal muscles upto the anus with injuries to the external anal sphincter \
Anal or the rectal canal may or may not be involved.
Must always be repaired surgically under anesthesia
Can cause considerable pain for many months and increases your risk of anal incontinence
Fourth-degree tear complete perineal tear. the vaginal tissue, perineal skin, and
perineal muscles that extends into the anal sphincter both external and internal as well as the rectal mucosa are torn
Third and fourth degree tears are more likely to be associated with complications, including infection, bleeding, anal incontinence, and increased pain
Urinating or having a bowel movement can be painful
Repaired surgically under anaesthesia in operation theatre
If symptoms associated with tear still presence, pt may be offered a caesarean section for next delivery to reduce the risk of further problems
In General… Spontaneous tear recover in the same or less time and often with
fewer complications than those who had an episiotomy
Most 3rd and 4th degree tears will heal in time but might experiences
Inability to control flatulence (breaking wind) Problems with your bowels including leakage, urgency and lack of
control Pain and soreness in the perineum Haemorrhoids Apprehensive towards sex Concerned about future deliveries Fistula (connection) between the anus and the vagina after the
repair has healed. This is uncommon and can be repaired by further surgery
Although episiotomy is an important risk factor for severe lacerations after vaginal delivery, there are other significant independent risk factors, such as maternal age, birth weight, and assisted vaginal delivery, that should be considered
(Angioli,Gomez,Cantuaria,O’ssulivian,2000)
Refrences Baby center.(2013).Perineal tears .Retrieved from :
http://www.babycenter.com/0_perineal-tears_1451354.bc?page=2 Linjen,J.(2012). Types of Spontaneous Vaginal Tears.Retrieved from:
http://www.healthline.com/health/pregnancy/cervical-vaginal-tears Baby center .(2011).Episiotomy.Retrieved From
http://www.babycenter.com/0_episiotomy_165.bc#articlesection2 Northern Lincolnshire & Goole Hospitals NHS Foundation Trust(2010).Perineal
tears. Retrieved From http://www.nlg.nhs.uk/IfP/single/IFP-0559.pdf Nursing Standard .(2007). Perineal tears and episiotomy Retrieved from:
http://nursingstandard.rcnpublishing.co.uk/archive/article-perineal-tears-and-episiotomy
Mazumdar,M.D.(n.d).Perineal tear after childbirth .Retrieved From:http://www.gynaeonline.com/perineal_tear.htm
Larsson ,P.G., Platz-Christensen,J.J., Bergman,B.,& Wallstersson ,G.(1991) Advantage or disadvantage of episiotomy compared with spontaneous perineal laceration.Retrieved From :http://www.ncbi.nlm.nih.gov/pubmed/1885090
Angioli ,R., Gómez-Marín, O., Cantuaria, G.,& O'sullivan ,M.J. Severe perineal lacerations during vaginal delivery: the University of Miami experience .Retrieved From :http://www.ncbi.nlm.nih.gov/pubmed/10819834
top related