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Perineal Tear Classification

Perineal Tear Classification

There are four different types of perineal tear. In this article we explore perineal tear classification in more detail.

"Before we contacted you we had no real idea that we had grounds for a medical negligence claim but after speaking to you it became clear that Wendy was indeed treated poorly. Chris Bird took the time to explain what was happening and kept us to speed. Our deepest gratitude to you all and Chris in particular."

Mr And Mrs H

If you have suffered a perineal tear and would like advice about a possible medical negligence claim, please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.

Claims Involving Birth Tears That Glynns Solicitors Have Settled

How are perineal tears classified?

Perineal tears range in severity. To help define the injury that has been sustained, medical practitioners devised a classification system that denotes the precise structures that have been damaged.

The classification system for perineal tears ranges from a first degree tear to a fourth degree tear. A first degree tear is the most minor and a fourth degree tear is the most severe. The precise perineal tear classification is outlined below:

  • First degree tear: laceration of the vaginal epithelium (the tissue lining the vagina) or perineal skin only.
  • Second degree tear: laceration of the vaginal epithelium, perineal skin, perineal muscles and fascia.
  • Third degree tear: laceration of the vaginal epithelium, perineal skin, perineal body and anal sphincters. Third degree tears can be further subdivided into:
    • 3a: partial tear of the external sphincter involving less than 50% thickness
    • 3b: tear of the external sphincter involving more than 50% thickness
    • 3c: external and internal sphincter torn
  • Fourth degree tear: laceration of vaginal epithelium, perineal skin, perineal body, anal sphincters and anal epithelium (the tissue underneath the anus).

Treating perineal tears

The treatment required for each type of perineal tear is different. That is why it is so important that medical practitioner diagnose the correct perineal tear, as this will ensure the correct treatment is provided.

First and second degree tears are relatively superficial injuries that may need a couple of stitches, or none at all. This can be done by the midwife in the delivery suite.

Third and fourth degree tear are much more complex injuries as they involved the anal sphincter complex. They will need to be sutured by a surgeon in an operating theatre.

The repair must be carried out shortly after the birth as this will give the patient the best chance of recovery. If there is a delay it is much harder to perform a repair, and the patient may be left with ongoing complications.

If a third or fourth degree tear was sustained, these complications can involve difficulty controlling the anal sphincter. This can lead to faecal incontinence and the need for a colostomy bag.

Delayed treatment of perineal tear

If there was a delay in treating your perineal tear, causing to suffer a poor outcome, you could be the victim of medical negligence. Please contact us to find out more.

Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.

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Testimonials

"Before we contacted you we had no real idea that we had grounds for a medical negligence claim but after speaking to you if became clear that Wendy was indeed treated poorly. Chris took the time to explain what was happening and kept us to speed. Our deepest gratitude to you all and Chris in particular."

"I would like to say a big thank you to you for making this whole process easy and relatively painless. You kept me informed throughout and you were always polite and courteous in all forms of communication. I would not hesitate to recommend you to friends and family, so a really big thank you and I wish you all the best in the future."

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