Repair of obstetric perineal lacerations.
Family physicians who deliver babies must frequently repair perineal lacerations after episiotomy or spontaneous obstetric tears. Effective repair requires a knowledge of perineal anatomy and surgical technique. Perineal lacerations are classified according to their depth. Sequelae of obstetric lacerations include chronic perineal pain, dyspareunia, urinary incontinence, and fecal incontinence. With lacerations involving the anal sphincter complex, particular attention must be given to anatomy and surgical technique because of the high incidence of poor functional outcomes after repair. An overlapping technique to repair the external anal sphincter, rather than the traditional end-to-end technique, is being investigated to determine if it might decrease the incidence of anal incontinence. Minimizing the use of episiotomy and forceps deliveries can decrease the occurrence of severe perineal lacerations.
Leeman
Lawrence
L
Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131, USA. lleeman@salud.unm.edu
Spearman
Maridee
M
Rogers
Rebecca
R
D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006801:Humans; D022125:Lacerations / Q000145:classification / Q000517:prevention & control / Q000601:surgery*; D010502:Perineum / Q000033:anatomy & histology / Q000293:injuries*; D049590:Postpartum Period; D011247:Pregnancy