Management of obstetrics tears
https://doi.org/10.4081/wpph.2016.6864
Accepted: 5 September 2016
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Objective: Aim of the study is to analyse the literature about the management of obstetric tears, in order to optimize clinicians work and women perineal care after spontanous delivery.
Methodology: Review of literature.
Results: After a correct definition of obstetric injuries (1,2,3,4, degree), we describe main risk factors (birth weight, nulliparity, induction of labour, epidural analgesia), the role of episiotomy (midline or mediolateral one), the correct clinical conduction of labour in the care of perineum and the principles and techniques (over lapping or end-to-end techinques, for sphinterial repair) of obstetric suturing. We define also the correct clinical management of severe obstetric injuries repair (suture as soon as possible to reduce bleeding and risk of infection, check equipment and count swabs before starting the procedures, good lighting, ask for more experienced assistance if in doubt regarding the extent of trauma or structures involved, use general anesthesia, ensure good anatomical alignment of the wound, rectal examination after completing the repair of III-IV degrees) and the corret management in postnatal period (follow up in prevision of other pregnancies).
Conclusions: Improving surgical skills of clinicians could preserve perineal dysfunction.
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