Third- and Fourth-degree Perineal Tears, Management (Green-top 29)

This is the second edition of this guideline, which was originally published in July 2001 under the same title. The overall risk of obstetric anal sphincter injury is 1% of all vaginal deliveries. With increased awareness and training, there appears to be an increase in detection of anal sphincter injury. Obstetricians who are appropriately trained are more likely to provide a consistent, high standard of anal sphincter repair and contribute to reducing the extent of morbidity and litigation associated with anal sphincter injury. Obstetric anal sphincter injury encompasses both third- and fourth-degree perineal tears. A third-degree perineal tear is defined as a partial or complete disruption of the anal sphincter muscles, which may involve either or both the external (EAS) and internal anal sphincter (IAS) muscles. A fourth-degree tear is defined as a disruption of the anal sphincter muscles with a breach of the rectal mucosa.

This guideline can be downloaded as a pdf using the link below.

Date published: 01/03/2007

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