Perineal tears – A review

Goh, Ryan; Goh, Daryl; Ellepola, Hasthika

doi:10.31128/afp-09-17-4333

Cited by 79 publications

(64 citation statements)

References 28 publications

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“…It is divided in upper, mid, and lower segments. The upper segment is delimited by the "U"-shaped PRM; the middle segment is demarcated by the complete ring formed by the external sphincter; and the lower segment starts at the level where the internal sphincter gets thinner and ends, so only the EAS is visible 8,16,28 .…”

Section: Ultrasound Anatomy Of the Anal Canalmentioning

confidence: 99%

The role of 360° ultrasound in anal incontinence

Barois¹

2020

NGL

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Section: Ultrasound Anatomy Of the Anal Canalmentioning

confidence: 99%

The role of 360° ultrasound in anal incontinence

Barois¹

2020

NGL

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“…These sequelae can significantly influence maternal health and well‐being, including physical and sexual relationships, psychological well‐being and care of the infant 4,5 . Furthermore, how perineal trauma is managed and followed up has a substantial impact on the incidence and duration of pain and dysfunction experienced by women 2,3,6 …”

Section: Introductionmentioning

confidence: 99%

Perineal trauma management and follow‐up: Are we meeting the standard of care?

Peiris‐John

Park

Wells

et al. 2020

Aust NZ J Obst Gynaeco

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Background Birth‐related third‐ and fourth‐degree perineal trauma is common and associated with short‐ and long‐term complications. Aim To conduct a review of clinical audits investigating management of women with perineal trauma. Materials and Methods We identified all audits undertaken in eight New Zealand public hospitals between 2005 and 2014 that investigated whether women with birth‐related third‐ and fourth‐degree perineal trauma were receiving care according to clinical guidelines. We aggregated audit results and calculated the proportion of women receiving the recommended standard of care. Results During the review period, 25 audits investigated intra‐operative (n = 11), post‐operative (n = 14) and outpatient care (n = 18). Baseline audits showed variation in care by site; intra‐operative care (range 39–96% for repair conducted under anaesthesia, 60–96% for repair by or under supervision of a senior clinician, and 33–54% for completion of Accident Compensation Corporation forms); post‐operative care (range 40–93% for prescribed antibiotics and 33–96% for stool softeners) and outpatient care (45–84% for referral to outpatient clinic and 54–78% for physiotherapy follow‐up). Sustained high quality of care and improvements in adherence with recommendations were seen for most of the follow‐up audits (eg 90% adherence for prescribed stool softeners over three audits; over 50% increase in prescribed antibiotics over seven years). Conclusions These clinical audits exemplify the need to measure patient care against standards, learn from the findings, implement changes to improve patient experience and reduce life‐long sequelae from perineal trauma. This review showed some progress in some care services and highlighted where further changes are needed to close evidence‐practice gaps.

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“…Anterior trauma of perineum may include; anterior wall of vagina, labia, urethra and clitoris. Posterior trauma of perineum could affect the posterior wall of vagina, perineal muscle & body, internal & external anal sphincters and anal canal (Goh et al, 2018: Mohamed, Ahmed, Hassan 1& Hassan, 2017.Many obstetricians considered the most recognized and adopted classification of perineal trauma was done by The Royal College of Obstetricians and Gynecologists, they classified perineal tears into four degrees;1 st degree, vaginal mucosa only involved; 2 nd Degree: vaginal mucosa and perineal muscles involved; 3 rd Degree tearwhenanal sphincter involved;…”

Section: Introductionmentioning

confidence: 99%

“…Another technique known as hands off maneuver, the midwife role is to monitor only and follow the progress of baby delivery and apply slight pressure in case of rapid expulsion and without touching the perineum the baby born(National Institute for Health and Care Excellence( NICE). 2019; Goh et al, 2018:Rezaei, Sussan, Huak& Sharif, 2014 Regarding the rate of perineal trauma, it"s noticed that there is no significant difference between hands on and hands off methods but the 3 rd degree tear was noticed to be less in hands off method. Other researches revealed that hands-off or hands on techniques are prevalent in decreasing therate of obstetric anal sphincter injury (Queensland Clinical Guidelines QCG, 2017: Foroughipour, Firuzeh, Ghahiri, Norbakhsh&Heidari.…”

Section: Introductionmentioning

confidence: 99%