The Obstetrician & Gynaecologist 2007;9:3:164-170
doi: 10.1576/toag.9.3.164.27336
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
Postpartum care of the perineum
Myra Fitzpatrick, MRCOG, Lecturer1 and
Colm O'Herlihy, FRCOG, Professor of Obstetrics and Gynaecology2
1. National Maternity Hospital Department of Obstetrics and Gynaecology Holles Street, Dublin 2 Republic of Ireland Email: myrafitzpatrick{at}hotmail.com (corresponding author)
2. National Maternity Hospital Dublin, Republic of Ireland
Key content:
- Vaginal birth is traumatic to the pelvic floor and perineum.
- Faecal incontinence, perineal pain, urinary incontinence and dyspareunia can all be long-term effects of such damage.
- Recognition and management of perineal trauma postpartum is vital.
- Women rarely volunteer information regarding faecal incontinence and dyspareunia.
- A dedicated pelvic floor clinic may be the most appropriate setting in which to care for women who are affected.
Learning objectives:
- To learn about the guidelines in place for the repair of perineal trauma following delivery.
- To recognise that anal sphincter damage may require follow-up and appropriate investigation.
- To learn that direct questioning of women about dyspareunia and faecal incontinence is necessary to elicit information.
Ethical issues:
- Is it the responsibility of women to present with their problems or should nursing and medical staff look for them?
- Financial constraints inappropriately limit the provision of small, highly focused clinics.
Please cite this article as: Fitzpatrick M, O'Herlihy C, Postpartum care of the perineum. The Obstetrician & Gynaecologist 2007;9:164–170.
Keywords biofeedback physiotherapy / obstetric anal sphincter injury / pelvic floor assessment / perineal trauma / vaginal delivery
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
