LabourFree in the app
Perineal tears
Classification — if unsure, choose the higher grade.
Source: RCOG GTG 29Degree
| 1st | Skin and/or vaginal mucosa. |
|---|---|
| 2nd | Perineal muscles, not anal sphincter. |
| 3a | <50% of external anal sphincter (EAS). |
| 3b | >50% of EAS. |
| 3c | EAS and internal sphincter (IAS). |
| 4th | EAS, IAS and anorectal mucosa. |
| Buttonhole | Rectal mucosa torn, sphincter intact — not 4th degree. |
Do a rectal examination on every woman before suturing. 3rd/4th degree: repair in theatre.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.