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Childbirth Trauma pp 119–130Cite as

Management of Childbirth Injury

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Abstract

Perineal trauma is the most common form of morbidity experienced during childbirth. Accurate assessment by an appropriately qualified professional and adequate analgesia are essential before undertaking repair. Repair should be undertaken as soon as possible after delivery, with good lighting, and an aseptic technique. The principles of repair of second, third and fourth degree tears are outlined in this chapter. There appears to be insufficient evidence to recommend either overlapping or end to end repair of the external anal sphincter in terms of continence outcomes. Symptoms of anal incontinence are seen in up to 43 % of women following obstetric anal sphincter injury, but the aetiology of this is likely to be multifactorial. Careful debriefing and assessment post-natally is of importance, and this is ideally done within a specialized clinic such that persisting symptoms can be managed effectively in a standardized manner. Advice for management in subsequent pregnancies will depend on factors such as symptoms of anal incontinence, endoanal scan and anorectal manometry findings, as well as patient choice.

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Author information

Authors and Affiliations

  1. Obstetrics and Gynaecology, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, UK

    Maya Basu BSc (Hons), MRCOG, MD (Res)

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  1. Maya Basu BSc (Hons), MRCOG, MD (Res)
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Correspondence to Maya Basu BSc (Hons), MRCOG, MD (Res) .

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Editors and Affiliations

  1. St George's University of London, London, United Kingdom

    Stergios K Doumouchtsis

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Basu, M. (2017). Management of Childbirth Injury. In: Doumouchtsis, S. (eds) Childbirth Trauma. Springer, London. https://doi.org/10.1007/978-1-4471-6711-2_9

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  • DOI: https://doi.org/10.1007/978-1-4471-6711-2_9

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  • Print ISBN: 978-1-4471-6710-5

  • Online ISBN: 978-1-4471-6711-2

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