Episiotomy-Related Perineal Injury During Spontaneous Vaginal Delivery

Abstract

Aim: Perineal tear a common occurrence during vaginal delivery. In this study, we present patients who underwent surgical intervention due to iatrogenic perineal tears during vaginal delivery. Method: We retrospectively reviewed patients who had iatrogenic perineal tear during normal vaginal delivery and for whom consultation by the general surgery unit was requested between May 2017 and December 2017. Results: Mean age of the patients was 27 years. Mean follow-up after surgery was one week. All patients underwent surgery due to grade 3A perineal tear after episiotomy with mediolateral incision during vaginal delivery under spinal anesthesia. Mean birth weight of the delivered infants was 3331 g and mean head circumference was 34.7 cm. Sphincter tone was reduced in digital rectal examination on postoperative day 1, and improved but still lower than normal on day 7. Three patients (42.8%) had gas incontinence, while no patients had fecal incontinence. Conclusion: Anorectal injuries are managed by surgical interventions which vary depending on time to intervention, severity of injury, severity of fecal contamination, presence of comorbid injuries, the patient’s general health status, and the surgeon’s preference and experience. Primary repair should be preferred in case of early diagnosis.

Keywords

• Episiotomy
• rectal injury
• treatment