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Vaginal Laceration

(Laceration, Vaginal; Vaginal Tears; Tears, Vaginal)

Definition

Vaginal lacerations are tears in the vagina or in the skin and muscle around the vaginal opening. Tears most commonly occur in the perineum. The perineum is the area between the anus and the opening of the vagina.
There are 4 degrees of vaginal laceration:

Causes

The deeper vaginal lacerations may occur during vaginal delivery. Examples of causes include:
Minor lacerations can occur during sexual intercourse.

Risk Factors

Factors that may increase your risk of a vaginal laceration include:

Symptoms

Vaginal lacerations may be painful, but there are usually no other symptoms.

Diagnosis

Your doctor will be with you during labor and will see any tearing if it happens. The seriousness will be based on the size of the tears and what muscles are affected. If the doctor thinks you may tear during pushing, an episiotomy may be advised. This is a surgical incision of the perineum. An episiotomy will make the vaginal opening temporarily larger so that the baby does not tear the vagina or the surrounding muscles.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Suturing

First degree tears are superficial. They often do not require stitches and will heal naturally. Second degree tears are deeper into the tissue, require a few stitches, and heal well afterward. Third and fourth degree tears require more stitches to be repaired correctly.
Stitches to Repair Third Degree Tear
vaginal tear surgical repair
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Prevention

To help reduce your chance of getting vaginal laceration, take the following steps:

RESOURCES

The American Congress of Obstetricians and Gynecologists http://www.acog.org

Women's Health—US Department of Health and Human Services http://www.womenshealth.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Women's Health Matters http://www.womenshealthmatters.ca

References

Clinical management guidelines for ostetrician: gynecologists. ACOG Practice Bulletin. 2000;17.

Leeman L, Sprearman M, Rogers R. Repair of obstetric perineal lacerations. Am Fam Physician. 2003;68(8):1585-1590.

Perineal massage in pregnancy. American College of Nurse-Midwives website. Available at: http://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000000656/Perineal%20Massage%20in%20Pregnancy.pdf. Published January/February 2005. Accessed March 29, 2016. Perineal trauma and repair in labor and delivery. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated November 23, 2015. Accessed March 29, 2016.

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