Question

A patient delivered at home with a complete perineal tear came to the hospital after 2 weeks. What management will you prefer ?

• A. Immediate repair
• B. Repair 3 weeks post-delivery
• C. Repair 6 weeks post-delivery
• D. Repair 3 months post-delivery

Answer 1

The Correct Option is D

In the context of obstetrics and gynecology, a "complete perineal tear" refers to a severe laceration that extends through the vaginal tissue, perineal skin, and the anal sphincter complex. Managing such a tear appropriately is crucial to ensure proper healing and to maintain functional integrity.

When a patient presents with a complete perineal tear 2 weeks postpartum, immediate repair is not typically recommended due to the significant risk of infection and poor healing in the recently traumatized tissue. Instead, it is advisable to allow inflammatory and reparative processes to stabilize the area before surgical intervention.

The most appropriate management in this situation is to delay the repair until adequate tissue healing and resolution of postpartum changes have occurred. This is optimally achieved by waiting for about 3 months post-delivery. At this time, tissues have generally healed sufficiently, reducing inflammation and edema, thus providing a suitable environment for a successful surgical repair.

Hence, the preferred management for a complete perineal tear in this scenario is to repair 3 months post-delivery.