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Perineal Tear: Ahmednagar Homoeopathic Medical College & Hospital Ahmednagar

This document summarizes a seminar on perineal tears presented by Ms. Bhagat Jayashree and guided by Dr. Pande at Ahmednagar Homoeopathic Medical College & Hospital. It defines perineal tears as lacerations that occur in women during childbirth from vaginal stretching. Tears are classified from first to fourth degree based on depth of tissue involvement. Causes include the large size of the infant's head compared to the birth canal. Complications can include incontinence, pain, and dyspareunia. Homeopathic remedies discussed to aid healing include Aconite, Arnica, Arsenicum, and Bellis Perennis.

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Suhas Ingale
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84 views

Perineal Tear: Ahmednagar Homoeopathic Medical College & Hospital Ahmednagar

This document summarizes a seminar on perineal tears presented by Ms. Bhagat Jayashree and guided by Dr. Pande at Ahmednagar Homoeopathic Medical College & Hospital. It defines perineal tears as lacerations that occur in women during childbirth from vaginal stretching. Tears are classified from first to fourth degree based on depth of tissue involvement. Causes include the large size of the infant's head compared to the birth canal. Complications can include incontinence, pain, and dyspareunia. Homeopathic remedies discussed to aid healing include Aconite, Arnica, Arsenicum, and Bellis Perennis.

Uploaded by

Suhas Ingale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Seminar On

PERINEAL TEAR
Presented By –
Ms. Bhagat Jayashree

Guided By
Dr. Pande

Ahmednagar Homoeopathic Medical College & Hospital


Ahmednagar
INTRODUCTION
O In obstetrics, a perineal tear is a spontaneous
(unintended) laceration of the skin and other soft tissue
structures which, in women, separate the vagina from
the anus. Perineal tears mainly occur in women as a
result of vaginal childbirth, which strains the perineum.
Tears vary widely in severity. The majority are
superficial and require no treatment, but severe tears
can cause significant bleeding, long-term pain or
dysfunction. A perineal tear is distinct from an
episiotomy, in which the perineum is intentionally
incised to facilitate delivery.
Anatomy
O In a woman, an anatomical area known as the perineum separates the opening
of the vagina from that of the anus. Each opening is surrounded by a wall, and
the anal wall is separated from the vaginal wall by a mass of soft tissue
including:
O The muscles of the anus (corrugator cutis ani, the internal anal sphincter and
the external anal sphincter)
O The medial muscles of the urogenital region (the superficial transverse
perineal muscle, the deep transverse perineal muscle and bulbocavernosus)
O The medial levator ani muscles (puborectalis and pubococcygeus)
O The fascia of perineum, which covers these muscles
O The overlying skin and subcutaneous tissue[1]
O A perineal tear may involve some or all of these structures, which normally
aid in supporting the pelvic organs and maintaining faecal continence. [2]
Classification
O Tears are classified into four categories:
O First-degree tear: laceration is limited to the fourchette and superficial
perineal skin or vaginal mucosa
O Second-degree tear: laceration extends beyond fourchette, perineal skin and
vaginal mucosa to perineal muscles and fascia, but not the anal sphincter
O Third-degree tear: fourchette, perineal skin, vaginal mucosa, muscles, and
anal sphincter are torn; third-degree tears may be further subdivided into
three subcategories
O 3a: partial tear of the external anal sphincter involving less than 50%
thickness
O 3b: greater than 50% tear of the external anal sphincter
O 3c: internal sphincter is torn
O Fourth-degree tear: fourchette, perineal skin, vaginal mucosa, muscles, anal
sphincter, and rectal mucosa are torn
Cause
O In humans and some other primates, the head of
the term fetus is so large in comparison to the
size of the birth canal that term delivery is rarely
possible without some degree of trauma. As the
head passes through the pelvis, the soft tissues
are stretched and compressed. The risk of severe
tear is greatly increased if the fetal head is
oriented occiput posterior (face forward), if the
mother has not given birth before or if the fetus
is large
Complications
O First and second degree tears rarely cause long-term
problems. Among women who experience a third or
fourth degree tear, 60-80% are asymptomatic after
12 months. Faecal incontinence, faecal urgency,
chronic perineal pain and dyspareunia occur in a
minority of patients, but may be permanent. The
symptoms associated with perineal tear are not
always due to the tear itself, since there are often
other injuries, such as avulsion of pelvic floor
muscles, that are not evident on examination.
Homoeopathic Remedies
O Aconite. Contractions feel violent and intense,
producing a state of fear, panic and anxiety. This is a
major remedy for a precipitous labor where
contractions come on very suddenly. Woman fears she
will not make it through childbirth and/or is convinced
that she will die. Emotional shock and trauma of the
infant after a difficult birth when baby appears shocked
and frightened. A dose of Arnica is usually followed 30
minutes later if there has been physical trauma. Useful
for newborns with ophthalmia, jaundice, retention of
urine, neonatal asphyxia and post-circumcision.
O Arnica. Common anti-inflammatory remedy
given at the beginning of and hourly throughout
the labor. A dose of 200C can be given to mother
immediately after birth to prevent postpartum
hemorrhage, after surgical births (C-sections,
forceps or vaccuum extractions) to promote
healing and reduce swelling, bruising, risk of
infection, soft tissue damage (perineum or
abdomen) and to baby with swelling or bruising.
O Arsenicum. Indicated for anxious restlessness
leading to physical exhaustion and insonia.
Women who are compulsive and can’t let go.
Perineal infections following childbirth.
Newborn resuscitation in severely
depressed baby with little or no color or
respiratory effort.
O Bellis Perennis. After a miscarriage, a dose of
Arnica is given followed by a few doses of Bellis
Perennis, spaced 30 minutes apart. Soreness of
abdominal wall and sciatica caused by position
of baby during pregnancy. Wonderful remedy for
tears in the perineum or periurethral area after
birth (including episiotomy), helps control the
bleeding as well. Also indicated for bruised, sore
pelvic or abdominal tissues following birth or
Caesarean section.
THANK YOU....!!!

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