A third degree tear is a serious perineal tear sustained during a vaginal delivery. It must be repaired soon after the birth if a patient is to make a full recovery.
Repairing a third degree tear
A third degree tear is when the perineum tears during the delivery of a baby. This tear extends down to the external anal sphincter. If it is not repaired a woman will have compromised anal sphincter function, leading to problems such as the loss of sphincter control, faecal urgency and incontinence.
To ensure these complications do not occur, a third degree tear must be repaired shortly after the delivery. Once diagnosed, an experienced surgeon should be asked to carry out a repair. This might be a registrar or a consultant obstetrician. The procedure should be performed in an operating theatre and in good light.
During the repair itself, a woman will be given either regional or general anaesthetic and placed in the lithotomy position. The surgeon should then suture (stitch) the wound together, using whichever technique he/she believes is most suitable. The stitches will dissolve over the coming weeks so there is no need to have them taken out.
After the repair, post-operative management should continue until the injury is healed. Before being discharged from hospital, a woman should be given broad-spectrum antibiotics, laxatives and painkillers. She should also be advised on how to speed up the healing process with pelvic floor exercises and good hygiene.
The community midwife makes a number of home visits in the days and weeks after the birth and should enquire about a patient’s recovery. If any problems are reported, the midwife can carry out an examination and provide the appropriate advice. The third degree tear should also be reviewed by a consultant six to 12 weeks after the birth.
Failure to repair a third degree tear
If these steps are taken, a woman who has sustained a third degree tear stands a good chance of making a full recovery. However, problems will inevitably arise if a repair is not performed soon after the birth. Unless a patient is experiencing other, serious complications as a result of childbirth, there is no reason why a repair should not be carried out.
Failing to diagnose and repair a third degree tear is unacceptable and amounts to medical negligence. If this has happened to you, get in touch with us today to discuss what action you can take.
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