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Third degree tears and subsequent delivery
  1. J Costa,
  2. A Zawislak
  1. Royal Jubilee Maternity Hospital, Belfast, UK

Abstract

Introduction Overall risk of third degree tears (3DT) is about 1% of all vaginal deliveries and a previous 3DT increases the risks of recurrence in future vaginal deliveries.

Aim To identify the factors influencing the mode of delivery and to assess the perineal outcome in subsequent pregnancy following 3DT.

Methods 31 patients who have sustained 3DT during 2 years period and had a subsequent delivery were identified through computerised patient data. Two sets of notes were reviewed for each patient.

Results 10 mothers were unaware of the previous 3DT and these mothers were managed as low risk parous women during subsequent pregnancies. The Elective Caesarean section rate in this group was 2% compared to 33% in those who were known to have previous 3DT. There was no recurrence of third degree tears in the study group and the episiotomy rate was 57% in mothers who were known to have had a 3DT compared to 0% in those who were unknown.

Conclusion The single most important factor which influences the mode of delivery following 3DT and perineal outcome in subsequent pregnancy is the women's awareness of having a 3DT and the clinicians should provide more information to the women about the nature of the tear on discharge.

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