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Problems With Missed Third Degree Tears

After a vaginal delivery, a woman must undergo an adequate examination to assess whether or not she had sustained a birth injury, and if so how extensive this injury is.

This can be carried out by either a midwife or a doctor, but must involve an inspection of the vagina, perineum and rectum, as it is possible that damage is sustained to the anal sphincter. To verify whether such an injury has occurred, it is necessary for the medical professional to place a finger into the patient's rectum and a thumb into her vagina. The thumb and finger should then be used in a pin rolling motion to assess the palpable thickness of the tissue. With this the full extent of the tear (if there is one) should be recognised and a repair performed.

Consequences of a missed third degree tear

However, some women will unfortunately suffer damage to their anal sphincter, only for the injury to remain undiagnosed and repaired. This will happen for one of two reasons: either an adequate assessment was not carried out, or the medical professionals failed to accurately evaluate the extent of the injury.

Consequently, a woman will leave hospital without even knowing that she has a third or fourth degree tear. Nevertheless, she will soon begin to suspect that something is amiss, as unrepaired tears will lead to a series of problems. These may include incontinence of flatus (wind), faecal urgency, faecal incontinence and perineal pain.

It is likely that these symptoms will lead to further medical investigation, which will then conclude in a perineal tear being identified. But even once a correct diagnosis is made, a woman may continue to suffer problems. This is because secondary repairs after obstetric trauma are not always successful, particularly in the long-term.

A study carried out in 2000 looked at 38 patients who had undergone a sphincter repair after a missed third or fourth degree tear. Of these, none was fully continent to both flatus and stool. Only four were totally continent to solid and liquid stool, six had no faecal urgency and eight had no passive soiling. Therefore secondary perineal tear repairs have significant limitations and may not result in a full recovery.

Compensation for your missed tear

Evidently problems of this nature will be extremely distressing and will adversely affect the individual's life in a number of ways, from her ability to work to her relationship with her partner.

However, if this has happened to you, there is a way you can obtain a sense of justice, as you will be able to pursue a medical negligence claim. This is because failing to detect and repair a third or fourth degree tear after delivery will be considered negligent on the part of medical professionals. You will therefore be entitled to compensation for the damage this has caused.

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