Desgarro perineal grado IV

Abstract

In the present research work, a case study was carried out of a 24-year-old patient with a mid-day puerperium of 4 days of evolution, which presented pain at the perineal level of great intensity after complicated birth attended at the Health Centre of Pujilí, for the aforementioned, she comes again, is examined and in the episiorrhaphy site there is the elimination of purulent liquid of very bad smell with necrotic areas and vulvar oedema, due to the severity of the picture is transferred to the IESS Latacunga Hospital, which, after revaluate her, decide to perform a surgical cleaning that cannot be culminated by the elimination of faecaloid material and a perineal tear that involves the entire rectal mucosa, external and internal anal sphincter was evidenced; The case is communicated to coloproctology and its reference to the centre of the greater complexity of the IESS Ambato Hospital is processed for the resolution of the case. It is concluded that approximately 1 to 8% of women suffer severe perineal tear during childbirth as occurred in our patient. The precise indication for performing the episiotomy is to prevent the risk of perineal tear. The prevention of it originates from ante-natal counselling, adequate care of delivery and early identification of risk factors and signs of infection and the goal of treatment in these patients is the control of bleeding and the identification of type and injury grade is essential to make a correct repair.