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1 results

  • Case 56 - A 20-Year-Old with a Fourth-Degree Perineal Laceration

  • from Section 6 - Intrapartum/Delivery
  • Edited by Peter F. Schnatz, The Reading Hospital, Pennsylvania, D. Yvette LaCoursiere, University of California, San Diego, Christopher M. Morosky, University of Connecticut School of Medicine, Jonathan Schaffir, The Ohio State University College of Medicine, Vanessa Torbenson, Mayo Clinic Alix School of Medicine, David Chelmow, Virginia Commonwealth School of Medicine
  • Book:
    Pregnancy Complications
    Published online:
    08 April 2025
    Print publication:
    01 May 2025, pp 171-173

  • Summary

    Obstetric anal sphincter injuries (OASIS) are severe lacerations that extend into or through the anal sphincter complex. A thorough exam in the immediate postpartum period and familiarity with the anatomy is essential for the proper diagnosis and management. There is no difference in long-term complications regarding the use of an end-to-end anastomosis or overlapping technique to repair the external anal sphincter. It is reasonable to administer a single dose of a second-generation cephalosporin as antibiotic prophylaxis with third- and fourth-degree perineal lacerations. Proper postoperative care, including the avoidance of constipation, pelvic rest, good hygiene, pain control, and short-term follow-up visits, are key to avoiding complications.