Third Degree Tear

Objective: To know the incidence of third and fourth degree perineal tears, with the aim of reducing the incidence and improvement in management of women who sustain them. Methods: A Computer search of the midwife' database (Euroking) for the time period 1st Jan. 2000 to 31st Dec. 2000. Results: 74% of women in study had no episiotomies, only 26 % of ladies with episiotomies had perineal tears. The inference to be drawn was that episiotomies have protective effect if timely and adequately performed. In post natal follow-up visit 13 % of ladies had poor sphincter strength and they were referred to physiotherapy department for pelvic floor exercises. One patient underwent Fenton's Operation due to dyspareunia. Occasional incontinence was seen in 8 % of cases, which improved over the time without any intervention. Discussion & Conclusion: The classification of perineal tears in the literature is confusing and explains the inconsistency in definition by Doctors and midwives. The inference drawn from the study was that episiotomy has got protective role against perineal trauma (347 episiotomies were performed out of total 2450 deliveries, only 26 % of women in the study had perineal tears who had episiotomies. Doctors should pay more attention to note keeping.