During pregnancy, the soft birth canal undergoes a series of changes to adapt to delivery, such as tissue softening, increased elasticity, and a certain degree of extensibility. Despite these changes, when the fetus is delivered through the birth canal, the degree of dilation required is relatively large. Most women, especially first-time mothers, may still experience varying degrees of cervical, vaginal, and perineal damage during childbirth. The so-called birth canal laceration here refers to the laceration of the soft birth canal during childbirth.
The following is an introduction to the manifestations of birth canal laceration during childbirth: 1. Cervical laceration. When first-time mothers give birth, the cervix is often damaged, the degree is very slight, and the depth does not exceed 1 cm. There was neither bleeding nor other manifestations. If you don\’t check carefully, it is often not noticeable and can heal naturally after delivery. After healing, the external uterine opening was slightly relaxed and presented an oval transverse fissure. Doctors often use the transverse cervical fissure to identify multiparous or nulliparous women. If a deep tear occurs on the cervix during childbirth and there is varying degrees of bleeding, it is called a cervical laceration. Deep lacerations can be detected after birth.
In severe lacerations, the depth may reach the vaginal vault. After healing, irregular lacerations may be seen on the cervix, similar to a cleft lip.
2. Vaginal and perineal tears Vaginal wall and perineal tears are the most common complications during childbirth. Mild cases are limited to mucosal or skin damage; severe cases involve the deep vaginal wall and pelvic floor musculature and fascia; in severe perineal lacerations, the anal sphincter and anterior rectal wall are also torn. It can be seen that there is blood flowing out of the tear, and the bleeding volume is also large in severe and deep lacerations. Perineal lacerations are generally classified into three degrees, depending on their extent.
*First degree laceration. It refers to the tear of the skin and mucous membrane of the perineum or the mucous membrane of the vaginal wall. Some are smaller in scope and area, and some are wider.
*Second degree laceration. In addition to the skin and mucous membrane tears, the underlying muscles and fascia are also torn, but the anal sphincter remains intact.
*Third degree laceration. The wound was deep. In addition to the skin, mucosa, and muscles, the anal sphincter is also completely or partially torn, and the anterior rectal wall is often torn at the same time. Rupture of the anal sphincter and ectropion of the rectal mucosa are visible to the naked eye.
After a perineal laceration occurs, no matter how severe it is, it should be repaired and sutured immediately. When suturing, the edges of the wound need to be aligned neatly, with the hymen on the outside as a mark, and sutured layer by layer from the inside to the outside, leaving no gaps between tissues. When suturing, attention must be paid to aseptic operation and hemostasis to avoid hematoma and infection. Severe cervical lacerations should also be sutured immediately, while minor lacerations that do not bleed do not require treatment.
Further reading: Awareness of birth canal laceration is a major event that most women have to face. In the face of the upcoming childbirth process, in addition to whether the labor pain itself is bearable, whether the fetus passes through the birth canal, how much damage it will cause to the mother, and what kind of sequelae it will leave, are all issues of great concern. This article of.
Birth canal lacerations can generally be divided into vaginal lacerations and perineal lacerations, which are discussed separately below.
Perineal laceration The perineum mainly refers to the tissue between the vaginal opening and the anal opening. From personal experience, unless the fetus is less than 2000 grams or the mother has given birth to several babies, the perineum will definitely split. The advantage of an episiotomy is that the wound is neat and easy to suture, and the perineal wound will be more beautiful. Therefore, I personally recommend that most pregnant women have an episiotomy.