Obstetric anal sphincter injury is when the anal sphincter(s) become damaged during childbirth. In this article we explore obstetric sphincter injury in more detail.
How does obstetric anal sphincter injury happen?
During a vaginal birth, the mother’s perineum will stretch as the baby’s head and shoulders are delivered. Sometimes, however, the perineum will be unable to stretch far enough and it will tear. There are varying degrees of perineal tear, ranging from a first degree tear to a fourth degree tear.
Third and fourth degree tears involve an injury to the anal sphincter. A third degree tears sees the laceration extend from the vaginal opening, down to the perineum and into the external anal sphincter. A fourth degree tear is the same, only the tear extends to both the external and internal sphincters.
Repairing obstetric anal sphincter injuries
After the birth, a woman should be examined by a midwife or doctor. This should include a digital rectal examination, whereby a finger is inserted into the anus to establish whether or not there is a defect. If part of the anal sphincter is torn, a repair must be carried out by a specialist surgeon in theatre.
It is important for the injury to be repaired shortly after childbirth. If there is a delay, it will not be as easy to stitch the sphincter back together. Therefore a correct diagnosis is essential as this will ensure a timely repair, preventing ongoing symptoms.
Complications of an obstetric sphincter injury
Even with timely treatment, it is possible that obstetric sphincter injury will cause future problems, including the inability to control flatus (wind), faecal urgency and faecal incontinence.
Nevertheless, 60 to 80% of women who sustain such an injury are without symptoms after 12 months. The prognosis is much better in women whose injury is diagnosed and repaired shortly after the birth. If complications develop because a third or fourth degree tear is left undiagnosed and unrepaired, there will be a case of medical negligence.
Obstetric sphincter injury and medical negligence claims
Medical professionals must diagnose and repair perineal tears before a woman leaves a healthcare environment. If there is failure to do so and a patient goes home with an unrepaired tear, the level of care will be deemed substandard. If this causes complications to develop – such as faecal urgency and incontinence – there will be grounds for a medical negligence compensation claim.
To find out if you can claim compensation for your obstetric anal sphincter injury, get in touch with us today.
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