How is perineal laceration generally graded?

Perineal laceration usually occurs when a pregnant woman is giving birth. It is usually a tear caused when the fetus passes through the vagina during normal delivery. However, the physical condition of each pregnant woman is different, and the degree of tearing will also be different. Normally, perineal lacerations during childbirth are usually divided into several levels. Different levels of tearing are also different, and the impact on people is also different.

How is perineal laceration generally graded?

I degree

Location: Only the perineal skin and vaginal entrance mucosa are torn, including rupture of the labia and vestibule mucosa. ;

Symptoms: There are tears in the skin and mucous membrane of the perineum, or the mucous membrane of the vaginal wall, which may be very small or very large in range and area. Bleeding is not heavy;

Population: Common women who give birth for the second time.

Treatment: Mild perineal laceration, perineal epidermal surgery, can heal on its own without suturing.

II degree

Location: The perineal skin, mucosa, and muscles are lacerated, and the underlying muscles and fascia are also torn, but the anal sphincter remains intact.

Symptoms: The perineal fascia and muscle layer involve the mucosa of the posterior vaginal wall, extending to the grooves on both sides of the posterior vaginal wall and tearing upwards, the anatomical structure is difficult to identify, and there is a lot of bleeding;

Population: Common in first or second-time mothers, second-degree perineal laceration is the grade of laceration that occurs in most mothers.

Treatment: Moderate perineal laceration, with a depth that reaches the subcutaneous soft tissue or muscle but does not damage the anal sphincter, can heal after a simple repair with almost no sequelae.

Grade III

Location: The laceration extends deep into the perineum, the skin, mucosa, perineum body, and external anal sphincter have been ruptured, but the rectal mucosa is still intact;

Symptoms: In addition to the skin, mucous membranes and muscles, the anal sphincter is also completely or partially torn, and the anterior wall of the rectum is often torn at the same time. The ruptured anal sphincter and everted rectal mucosa can be seen with the naked eye.

Population: Common first-time mothers.

Treatment: timely surgical suture. Severe perineal lacerations, subcutaneous soft tissue injuries, and anal sphincter ruptures may lead to postpartum infection if not sutured in time.

IV degree

Location: The anus, rectum and vagina are completely connected, with the rectum cavity exposed. This is the most serious vaginal perineal tear.

Symptoms: Severe perineal laceration, the main feature of which is laceration of the anal sphincter and rectal mucosa. But the amount of bleeding is not much.

Population: Common first-time mothers.

Treatment: Suture promptly and correctly. Failure to do so may result in old perineal lacerations or even fecal incontinence.

Health Tips

The reason why women suffer from perineal lacerations is mostly due to improper handling of the delivery process and occasional trauma. According to experts, third and fourth degree perineal lacerations, or complete perineal lacerations, include lacerations of the vaginal opening, perineal lacerations and anal sphincter lacerations. In severe cases, the lacerations can extend to the rectal wall, causing fecal and gas incontinence.