Post Date August, 05 2023
Perineal laceration is a condition that occurs during childbirth and is also a vaginal injury. Reasonable methods should be taken during childbirth to effectively prevent this situation.
What is a perineal laceration?
Perineal laceration refers to that when the fetal head is about to pass through the Vaginal delivery of the parturient during delivery, the Vaginal orifice and surrounding tissues are compressed during the continuous descent of the fetal head, and local expansion and thinning. If the perineum is not protected, the perineum will be torn. In some cases, the tear may extend to the anus because the fetus is too large.
Perineal laceration can be divided into four degrees, with 1-2 degrees being mild laceration. If it is not very severe, no treatment is needed. If bleeding occurs, effective treatment is necessary to prevent wound infection. 3-4 degrees are severe perineal lacerations, and postpartum women need to be sutured.
Severe perineal laceration, if not treated promptly and effectively, can cause various complications, most commonly leading to inflammation of the perineal and sacrococcygeal skin. Some puerperal women's pudendal skin is red, swollen, ulcerated, infected with urethral orifice and Vaginal orifice, and perineal laceration also has an impact on postpartum sexual life.
In order to prevent severe perineal laceration during delivery, doctors observe the delivery process, accurately estimate the size of the fetus, and understand the position and exposed area of the fetus. If the delivery speed of the mother is found to be too fast or delayed during the delivery process, the doctor will perform a lateral perineal incision on the mother to avoid laceration. If the mother has already developed a laceration, the doctor will handle it according to the degree of the laceration. If the laceration is severe, suturing will be performed.
Fenyin laceration grading
1 degree perineal laceration: Mild perineal laceration, perineal epidermal surgery, self recovery without the need for suturing, common in postpartum women with secondary childbirth.
Degree 2 perineal laceration: moderate perineal laceration, the depth of laceration reaches subcutaneous soft tissue and muscle, but does not damage the anal muscles. This is the grading of lacerations that many mothers experience, which can be easily repaired without leaving any sequelae.
Degree 3 perineal laceration: severe perineal laceration, subcutaneous soft tissue injury, anal Sphincter rupture, and untimely suture may cause postpartum infection.
Degree 4 perineal laceration: severe perineal laceration, mainly characterized by laceration of anal Sphincter and rectal mucosa.
Manifestations of perineal laceration
Grade III perineal laceration occurs during the second production process, and when the fetal head has a coronal shape, the midwife may notice a cracking sensation in the perineum. Immediately after delivery, secondary laceration and suturing were found. Due to the different degree of rupture, the symptoms may also be severe, such as only partial tearing of the Sphincter and uncontrollable loose stool. In this situation, the patient tries to make their stool dry as much as possible. The control of stool mainly depends on the anal Sphincter, which will not cause sudden overflow of stool when the abdominal pressure increases. However, the autonomous control of stool reaction depends not only on the Sphincter, but also on the anal levator. In severe cases, even dry stools cannot be controlled, and the external genitalia is often contaminated with feces.
