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Vital Recording of 3rd Degree Tears

Vital Recording of 3rd Degree Tears

A severe perineal tear can transform a woman's life for the worse and impact dramatically on her ability to care for her new-born baby. An accurate repair following an accurate diagnosis is key to a good physical and psychological outcome.

What is a 3d degree tear?

A 3rd degree tear is an injury to the perineum (the area between the vagina and the anus) and the anal region that can occur naturally during vaginal childbirth. A mother who is giving birth vaginally for the first time and whose baby is large, or who requires an assisted birth, is more likely to experience this type of injury.

How do 3rd degree tears differ?

A 3rd degree tear starts at the vagina and tears the skin and muscle across the perineum as far as and including the anus. To provide further clarity, 3rd degree tears have been sub-classified according to the extent of the damage they cause to the anal sphincter, the muscles which control the opening and closing of the anus.

  • Grade 3a tear: less than 50% of the external sphincter thickness is torn
  • Grade 3b tear: more than 50% of the external sphincter thickness is torn
  • Grade 3c tear: both the external and internal sphincter are torn

This careful classification and an accurate recognition of the correct grade of injury are vital in supporting an appropriate and thorough surgical repair.

3rd degree tears and anal incontinence

Although all 3rd degree tears affect the muscles which control the anus, the extent of that injury is likely to have a significant impact on the long-term recovery of the woman. A number of different studies have all concluded that women who suffer a 3b tear or greater are more likely to experience long-term anal incontinence. Where the internal sphincter has been affected in addition to the external sphincter (a Grade 3c tear), the chances of severe incontinence are increased.

Anal incontinence is likely to affect the woman's ability to control both faeces and wind, leading to involuntary release of both. This can affect her ability to work and socialise.

Examining & Recording 3rd degree tears

Perineal tears are not easy to predict nor to prevent. Consequently, a thorough and high-quality repair is vital to the woman's long-term recovery. Where third (and fourth) degree tears are concerned, the likelihood of a competent repair is greatly enhanced by an accurate diagnosis and recording of the nature of the damage experienced.

If the woman has received a 3c tear damaging her internal anal sphincter but only a 3a tear is observed, her repair may not address the whole injury, leaving her vulnerable to unpleasant long-term symptoms.

Consequently, a thorough examination of the woman's perineum and rectum immediately after birth, including a digital rectal examination, are absolutely fundamental to identifying the level of damage, if any, that has occurred during the delivery of the baby.

Following such an examination, the accurate recording of the findings is also necessary to ensure that the subsequent surgical repair resolves the entire tear.

Inadequate Repair of a 3rd degree tear

If you experienced a tear during the birth of your child that was misdiagnosed leading to a poor long-term outcome, you may be entitled to make a claim for compensation.

Contact Glynns Solicitors to discuss your experiences. We are a specialist medical negligence practice with considerable experience of supporting claims for negligently-treated perineal tears.

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

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