Third degree anal sphincter tears: Risk factors and outcome

The aim of this retrospective study was to determine the incidence, risk fa ctors and anal symptoms related to third degree tears after vaginal deliver y, There were 9,631 vaginal deliveries during the 5-year period studied, wi th 116 (1.2%) having a third degree tear. Statistically significant risk fa ctors for a third degree tear were primiparity, forceps delivery, episiotom y, fetal birth-weight greater than 4,000 g and increased duration of the se cond stage of labour. Eighty four of the 116 women were able to be intervie wed, and 21 (25%) had anal symptoms related to the tear. Only 3 women had s ought help for their symptoms. Twelve women experienced anal incontinence a nd 3 more required delayed repair of the anal sphincter for incontinence. T hird degree tears are 3 major cause of perinatal and postnatal morbidity. A ttention needs to be directed to the prevention of such tears by awareness of the women at risk and to better follow-up and counselling of the women s ustaining a tear.