E-Posters-Perineal Breakdown after Vaginal Delivery: What Happens Next?

Perineal Breakdown after Vaginal Delivery: What Happens Next? - Samantha DeAndrade, MD, MPH

Pdf Summary

This study aimed to characterize the type, sequelae, and management of perineal breakdowns that occur following obstetric laceration repairs. The study included a retrospective cohort of women who delivered vaginally at one academic medical center between January 2015 and April 2018 and subsequently experienced symptomatic perineal breakdown. The most commonly reported symptoms were urinary incontinence, flatal incontinence, and pelvic pain, which improved over time but persisted after one year postpartum. Pelvic floor physical therapy may be an intervention worth studying to improve long-term outcomes for these patients. <br /><br />The study found that perineal breakdowns occurred in 1.02% of the 7,230 lacerations sustained during the study period. The breakdowns were characterized by superficial lacerations (69%) and involved vulvovaginal skin or vaginal epithelium alone, while 31% were deep full-thickness dehiscences. <br /><br />The management of perineal breakdowns varied, with 52% being expectantly managed, 40% repaired in the operating room, and 4% repaired in the office. Female Pelvic Medicine and Reconstructive Surgery specialists managed only 6% of the breakdowns, while the majority (79%) were managed by Obstetrics/Gynecology or Maternal Fetal Medicine specialists. <br /><br />The study highlights the importance of addressing the potential complications and sequelae of perineal lacerations, as they can significantly impact a woman's quality of life. Further research is needed to explore interventions such as targeted pelvic floor physical therapy to improve long-term outcomes for women who experience perineal breakdown following obstetric laceration repairs.

Keywords

perineal breakdowns

obstetric laceration repairs

symptomatic perineal breakdown

urinary incontinence

flatal incontinence

pelvic pain

pelvic floor physical therapy

superficial lacerations

full-thickness dehiscences

management of perineal breakdowns