Question:
A woman delivered at home with a complete perineal tear and presents to the hospital 2 weeks later. What management will you prefer?
A woman delivered at home with a complete perineal tear and presents to the hospital 2 weeks later. What management will you prefer?
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Past 24 hours the tissue is infected, so do not repair now; wait for healthy tissue.
Updated On: Jun 23, 2026
- Immediate repair
- Repair 3 weeks post-delivery
- Repair 6 weeks post-delivery
- Repair 3 months post-delivery
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The Correct Option is D
Solution and Explanation
Step 1: A fresh complete perineal tear should be repaired immediately after delivery of the placenta, as this lowers infection risk and limits blood loss.
Step 2: If the patient presents late, beyond 24 hours, immediate repair is withheld because the tissues are infected and oedematous and primary repair would break down.
Step 3: In a neglected (old) complete tear, the wound is allowed to granulate and heal, antibiotics are started, and definitive repair is deferred until the local tissues are healthy, which is about 3 months later.
This patient presents at 2 weeks, so repair is planned at 3 months.
Ref: Dutta Obstetrics, 24th ed (8th ed Eng), p. 490
Step 2: If the patient presents late, beyond 24 hours, immediate repair is withheld because the tissues are infected and oedematous and primary repair would break down.
Step 3: In a neglected (old) complete tear, the wound is allowed to granulate and heal, antibiotics are started, and definitive repair is deferred until the local tissues are healthy, which is about 3 months later.
This patient presents at 2 weeks, so repair is planned at 3 months.
Ref: Dutta Obstetrics, 24th ed (8th ed Eng), p. 490
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