Managing perineal trauma after childbirth

#### The bottom line Every year millions of women worldwide sustain trauma to the perineum when giving birth. Around 6% of these women will have short term wound complications such as infection and dehiscence.1 Some are also at risk of long term problems such as dyspareunia, pain, urinary and faecal incontinence, pelvic organ prolapse, and psychosocial problems. Correct assessment and repair of this trauma is therefore essential to help reduce long term complications. In this review we focus on the management of childbirth related perineal trauma that does not involve injury to the anal sphincter complex (this has been dealt with previously2)—that is, first and second degree perineal trauma. We provide healthcare professionals caring for women during childbirth and the postnatal period with an overview of the current best evidence for the assessment, repair, and postnatal management of perineal trauma to reduce the incidence of complications in the short and long term. #### Sources and selection criteria We searched Medline and Embase from 1980 to date, limited to publications in English and to studies in women. Our search strategy used a combination of MeSH, textwords, and appropriate word variants of “perineal” or “trauma” and “obstetric” or “labour”. We supplemented these …