Perineal tear

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
Philadelphia GLP-1 weight loss and GLP-1 clinic NYC

Perineal tear
Synonyms	Perineal laceration
Pronounce	N/A
Specialty	N/A
Symptoms	Pain, bleeding, swelling in the perineal area
Complications	Infection, urinary incontinence, fecal incontinence
Onset	During childbirth
Duration	Varies, typically weeks to months
Types	First-degree, second-degree, third-degree, fourth-degree
Causes	Vaginal delivery, episiotomy
Risks	Large baby, prolonged labor, use of forceps or vacuum
Diagnosis	Physical examination
Differential diagnosis	Episiotomy, vaginal tear
Prevention	Perineal massage, controlled delivery
Treatment	Surgical repair, pain management
Medication	Analgesics, antibiotics
Prognosis	Generally good with treatment
Frequency	Common in vaginal deliveries
Deaths	N/A

Perineal Tear

Transactions of the American Association of Obstetricians and Gynecologists for the year (1919)

A Perineal Tear is a laceration of the skin and other soft tissue structures which, in women, separate the vagina and the anus. Perineal tears mainly occur in women as a result of vaginal childbirth, which strains the perineum.

Types of Perineal Tears

Perineal tears are classified into four degrees, with the first degree being the least severe and the fourth degree being the most severe.

• First-degree tear: A first-degree tear is a small tear of the skin of the perineum. It may cause some discomfort and may require stitches.
• Second-degree tear: A second-degree tear is a deeper tear that involves the perineal muscles. This type of tear usually requires stitches and heals within a few weeks with appropriate care.
• Third-degree tear: A third-degree tear is a severe tear that extends into the muscle that surrounds the anus (anal sphincter). This type of tear requires surgical repair and can result in long-term problems with bowel and bladder control if not properly treated.
• Fourth-degree tear: A fourth-degree tear is the most severe type of perineal tear. It extends through the anal sphincter and into the tissue lining the rectum (rectal mucosa). This type of tear requires surgical repair and can result in long-term problems with bowel and bladder control if not properly treated.

Causes of Perineal Tears

Perineal tears are most commonly caused by vaginal childbirth. Other factors that can increase the risk of a perineal tear include:

• A large baby
• A long labor
• The use of forceps or a vacuum device to assist with delivery
• A previous perineal tear

Treatment of Perineal Tears

The treatment of a perineal tear depends on the severity of the tear. First and second-degree tears usually heal on their own with appropriate care. Third and fourth-degree tears require surgical repair.

Prevention of Perineal Tears

There are several strategies that can help to prevent perineal tears during childbirth, including:

• Perineal massage during pregnancy
• Warm compresses applied to the perineum during labor
• Controlled pushing during delivery
• The use of certain birthing positions

See Also

• Childbirth
• Vagina
• Anus
• Anal sphincter
• Rectal mucosa