(Laceration, Vaginal; Vaginal Tears; Tears, Vaginal)
DefinitionVaginal 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 four degrees of vaginal laceration:
- First—superficial lacerations of the skin or vagina; often no repair is needed.
- Second—deep laceration involving the skin or vagina and underlying fatty tissue; a simple suture repair is needed.
- Third—deeper laceration involving the muscles of the anus (sphincter); suture repair of the muscle and the vagina is needed.
- Fourth—most extensive laceration involving the entire thickness of the vagina, sphincter, and through the inner lining of the rectum (rectal mucosa); suture repair of the vagina, muscle, and rectal mucosa is needed.
CausesThe deeper vaginal lacerations may occur during vaginal delivery . Examples of causes include:
- Delivering a baby whose head is too large to easily fit through the vaginal opening
- Going into labor too quickly (without giving the perineum time to stretch)
- Having a difficult vaginal delivery and needing assistance with forceps or vacuum extraction
Risk FactorsTell your doctor if you have any of these risk factors:
- Having a very large baby
- Having a baby for the first time
- Having had lacerations in prior pregnancy
SymptomsThere are usually no symptoms of vaginal laceration.
DiagnosisYour 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, she may recommend an episiotomy . 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.
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