Diseasewiki.com

Home - Disease list page 153

English | 中文 | Русский | Français | Deutsch | Español | Português | عربي | 日本語 | 한국어 | Italiano | Ελληνικά | ภาษาไทย | Tiếng Việt |

Search

Perineal laceration

  Perineal degree III laceration or complete perineal laceration, including vaginal orifice laceration, perineal laceration, and anal sphincter laceration. In severe cases, the rupture can extend to the rectal wall, causing feces and gas incontinence. The cause is often due to improper handling during the process of childbirth, and occasionally due to trauma. With the vigorous promotion of the new method of delivery, midwives appropriately protect the perineum, greatly reducing the incidence of degree III perineal laceration.

 

Table of Contents

1. What are the causes of perineal laceration?
2. What complications are likely to be caused by perineal laceration?
3. What are the typical symptoms of perineal laceration?
4. How to prevent perineal laceration?
5. What laboratory tests are needed for perineal laceration?
6. Diet taboos for patients with perineal laceration
7. Routine methods of Western medicine for the treatment of perineal laceration

1. What are the causes of perineal laceration?

  The causes of perineal laceration are often due to improper handling during the process of childbirth, and occasionally due to trauma. During the observation of the labor process, it is very important to correctly estimate the size, position, and presentation of the fetus, as well as to prevent early labor. It is necessary to perform a median episiotomy for women with posterior fontanelle and outlet stenosis during the operation of forceps delivery, and it can also be done bilaterally if necessary, with attention to protecting the perineum. A median episiotomy has its advantages when performed by a skilled operator; however, if the operation technique is not skilled and the perineum is not well protected, the wound at the median episiotomy may continue to tear backward, leading to degree III laceration, which is something worth paying attention to.

 

2. What complications are likely to be caused by perineal laceration?

  The most common complications of perineal laceration are skin inflammation and pressure ulcers (bedsores) in the perineal and sacral tail areas. Due to the stimulation of feces, the perineal skin is often in a moist and metabolite erosion state, prone to redness, swelling, and ulceration. Skin ulcer infection can extend to the muscular layer or extend to the scrotum, labia, inguinal area, etc.; contamination of the urethral orifice and vaginal orifice can cause retrograde infection. Complications not only increase the patient's pain but also bring difficulties to clinical nursing work.

3. What are the typical symptoms of perineal laceration?

  Perineal lacerations can be divided into three degrees according to the degree of laceration, as follows:
  1. Degree I perineal laceration: Perineal skin and mucosal laceration, including the labia and vestibular mucosal rupture.
  2. Degree II perineal laceration: Perineal skin, mucosa, and muscle laceration, but the anal sphincter is intact.
  3. Degree III perineal laceration: Occurs during the second stage of labor, when the fetal head is crowning, the pregnant woman may feel a tearing sensation in the perineal area. Immediate discovery and suture of degree III laceration after delivery. Due to the varying degree of rupture, the symptoms may vary in severity. If only part of the sphincter is torn, it may only be unable to control diarrhea when the stool is loose. In this case, the patient tries to make the stool dry. The control of stool mainly relies on the anal sphincter, which does not cause the stool to overflow suddenly when the abdominal pressure increases. However, the voluntary control of stool response not only relies on the sphincter but also on the levator ani muscle. Severe cases may not be able to control dry stool, and the vulva is often contaminated by stool.
 

4. How to prevent perineal tears

  For the pathogenic factors, do a good job of prevention, which can significantly reduce the incidence rate. The following are the preventive measures:
  1. Do a good job of family planning. Multiple births and multiple deliveries inevitably lead to relaxation and tearing of the pelvic floor muscles.
  2. Immediate repair of perineal tears after childbirth to avoid wound infection and affect healing.
  3. For the first-time mother, the perineum is tight, and the presenting part stays in the perineum for a long time. To avoid submucosal muscle tearing or necrosis, perineal incision should be performed.
  4. Postpartum physical therapy, generally starting the second day after childbirth, to improve pelvic blood circulation, improve local muscle tension, enhance overall health, and avoid heavy physical labor or persistent coughing.

5. What laboratory tests are needed for perineal tears

  During the examination of perineal tears, the perineum is invisible, the distal end of the vagina and rectum are相通, the skin behind the anus presents radial wrinkles, and the retracted ends of the sphincter muscles form small indentations on both sides of the anus. During rectal examination, the patient is asked to contract inward, which can test the control function of the sphincter muscles. If the rectum is also torn, the rectal mucosa appears red and flips out.

  

6. Dietary taboos for patients with perineal tears

  In addition to conventional Western medicine treatment, attention should also be paid to some aspects of diet. Patients should consume more high-fiber foods and drink more water to avoid constipation. It is not advisable to over-nourish or consume spicy and warm foods, etc., to avoid exacerbating the condition.

7. Conventional methods of Western medicine for treating perineal tears

  Perineal tear repair during childbirth, also known as the repair method for fresh perineal Ⅲ degree tear, should be performed immediately after the placenta is delivered, under the condition that the patient's general condition allows it.
  The postpartum treatment of perineal tear repair is basically the same as that of old tear repair. Old tear repair refers to poor wound healing after perineal tear repair during childbirth, or undetected perineal tear after childbirth, which becomes an old (Ⅲ degree) tear. The repair time must be after 6 months postpartum.

Recommend: Mixed tubular acidosis , Xanthogranulomatous pyelonephritis , Intussusception syndrome , Cecum volvulus , Perineal hernia , Cold stagnation in the liver meridian syndrome

<<< Prev Next >>>



Copyright © Diseasewiki.com

Powered by Ce4e.com