RT Book, Section
A1 Yeomans, Edward R.
A1 Hoffman, Barbara L.
A1 Gilstrap III, Larry C.
A1 Cunningham, F. Gary
SR Print(0)
ID 1138214440
T1 Episiotomy and Obstetric Anal Sphincter Lacerations
T2 Cunningham and Gilstrap's Operative Obstetrics, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071849067
LK obgyn.mhmedical.com/content.aspx?aid=1138214440
RD 2024/04/19
AB Injury  to  the  perineum  during  vaginal  childbirth  affects  millions  of  women.  One  half  to  three  quarters  of  parturients  undergo  some  degree  of  perineal  laceration  during  vaginal  childbirth.  However,  rates  vary  considerably  by  locale  and  provider  (Low,  2000;  Webb,  2002).  Some  lacerations  occur  spontaneously  during  delivery.  Or,  an  obstetric  provider  may  cut  an  episiotomy  to  increase  the  vaginal  outlet  size  to  aid  the  birth.  Either  may  result  in  both  short-  and  long-term  symptoms  and  complications.  Initially,  most  women  experience  at  least  temporary  discomfort  or  pain  after  perineal  lacerations,  and  one  in  five  will  report  long-term  issues,  such  as  dyspareunia  (Glazener,  1995).  Additional  complications  include  physical,  psychologic,  and  social  problems,  which  all  may  affect  a  woman's  ability  to  care  for  her  newborn  and  family  (Sleep,  1991).  The  most  severe  perineal  lacerations  involve  the  anal  sphincter,  and  these  are  termed  obstetric  anal  sphincter  injuries  (OASIs).  These  tears  and  their  consequences  are  described  in  detail  throughout  this  chapter.