Curriculum of Obstetrics
TOPIC 39
GENITAL TRACT INJURY DURING LABOR
RATIONALE
Genital tract injury is a common complication of delivery. The injury may affect the genital tract as well as the urethra, bladder, and/or rectum.
GOAL
Acquire knowledge of the basic physiological changes of the genital tract during labor, and enumerate the sites of possible genital tract trauma, stressing perineal tears, vaginal lacerations, and cervical tears
LEARNING OBJECTIVES
By the end of this course, the student will be able to:
l Mention the sites of possible genital injury in labor
l Enumerate physiological changes in the vagina and vulva during labor
l List causes of perineal tears, types, and complications, and describe perineal repair with pre- and postoperative care
l Enumerate types of vaginal lacerations, methods of repair, and complications of laceration repair
l Describe the causes, types, complications, and methods of repair of cervical tear
l State the relationship between obstetric trauma and genital prolapse and incontinence later on
l Appreciate the value of rapid intervention
l Appreciate preventive obstetrics to avoid prolapse or incontinence
CONTENT
l Lacerations of the cervix
l Rupture of the vaginal vault
l Vaginal lacerations and para-vaginal hematoma
l Vulval lacerations
l Perineal tear
