Birth Injuries: Degrees of Perineal Tears
Perineal tears are birth injuries which are graded by the degree of their severity. Although the vast majority of such lacerations are minor, the following specifications are indicative of the grade of tear that may have occured during delivery:
- First Degree Perineal Tear: A 1st degree perineal tear is a very minor birth injury and refers to the fact that the damage is mild, perhaps with a small laceration to the vaginal opening. The lower end of the vagina may also have a small cut and the perineal skin may also be slightly damaged but major muscles remain intact.
- Second Degree Perineal Tear: 2nd degree perineal tears are more serious since the muscles of the perineum are involved. The muscles are ruptured and there will be deep tears in the vaginal wall. The tear may extend to the anus, but the anal sphincter will remain intact.
- Third Degree Perineal Tear: A 3rd degree perineal tear is the most serious type of tear. This birth injury means the tear extends from the vaginal wall, through the perineal muscles up to the anus and including injuries to the external anal sphincter muscle. In some instances the anal or rectal canal may also be involved although this is not always the case.
- Fourth Degree Perineal Tear: A 4th degree tear involves internal and external tearing of the anal sphincter muscle and the anal mucosa.
