OBSTETRIC LACERATIONS
Perineal lacerations are classified by the extent of tissue disruption between the
vaginal introitus and the anus.
First degree: involve only the vaginal mucosa. Suture repair is often not
needed
Second degree: involve the vagina and the muscles of the perineal body but
do not involve the anal sphincter; suturing is necessary
Third degree: involve the vagina, the perineal body, and the anal sphincter
but not the rectal mucosa; suturing is necessary to avoid anal incontinence
Fourth degree: involve all the way from the vagina through to the rectal
mucosa; complications of faulty repair or healing include rectovaginal fistula