A third degree tear is an injury that can be sustained by a woman during a vaginal delivery. The injury involves the perineum and external anal sphincter.
Causes of a third degree tear
Perineal tears happen as the baby’s head and shoulders are delivered. While there is a significant degree of elasticity in the vaginal opening and perineum, it is possible that this will not be enough to allow the passing of the baby’s head. Consequently the pressure exerted upon the tissue during the delivery will cause it to tear.
There are varying degrees of perineal tear: first and second degree tears are superficial injuries, while third and fourth degree tears are deep injuries that extend to the anal sphincters.
Third degree tears do not happen to everyone, with the Royal College of Obstetricians and Gynaecologists estimating that each year around 9% of women will suffer a severe tear in the UK. This means that in some women, the tissue will stretch far enough to ensure the safe passage of the baby, without the surrounding tissue sustaining any damage.
Risk factors
As a rule, third degree tears can affect any woman giving birth by way of vaginal delivery. It is not possible to determine exactly who will experience a third degree tear before the onset of labour. Nevertheless, there are certain factors that increase the likelihood of a severe tear occurring.
The risk factors for third degree tears have been identified in a number of retrospective studies. These include:
- Birth weight over 4kg
- First time giving birth vaginally
- Epidural analgesia
- Second stage of labour longer than one hour
- Shoulder dystocia
- Assisted delivery – e.g. forceps delivery
These factors will predispose a patient to the development of a third degree anal injury during a vaginal delivery.
Repairing a 3rd degree tear
If a third degree tear does happen, it must be repaired immediately after the birth by a qualified surgeon. The Royal College of Obstetricians and Gynaecologists states that “women should be advised that the prognosis following an EAS [external anal sphincter] repair is good, with 60-80% asymptomatic at 12 months.”
Thus as long as a repair is conducted shortly after the birth, a patient stands a very good chance of making a full recovery. Problems will arise, however, if a repair is not carried out. This is because a defect will remain in the anal sphincter, making it difficult to control the passing of wind and faeces.
If problems do occur because a third degree tear was not repaired after the birth, the patient will be entitled to pursue a compensation claim. Contact us today to find out more.
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