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dc.contributor.authorVan der Walt, R
dc.contributor.authorEllepola, H
dc.description.abstractBackground: OASIS injuries are a relatively common complication of vaginal deliveries; however, buttonhole tears are less common. A literature review identified no cases of buttonhole tears greater than 3 centimetres. Case: A 33-year-old primigravida woman underwent an induction of labour for decreased fetal movements and had a NVD of a 3.7 kg at 39 6/7 gestation infant with examination revealing a posterior vaginal wall tear. On routine per rectal exam post-suturing, a full thickness tear through rectovaginal fascia was identified Further assessment in theatre confirmed an extensive 10 cm full thickness rectal buttonhole tear with a completely intact sphincter complex, repaired with colorectal assistance. At review in the multidisciplinary clinic 6 months post-operatively, she reported good continence of faeces and flatus. Discussion: A literature review identified very few similar cases of isolated buttonhole tears with no anal sphincter involvement. This may be due to its rarity but also possibly due to under-reporting. No cases documenting a tear beyond 3 centimetres was identified, making this an unusual occurrence. Rectal buttonhole tears are a rare but potentially serious complication of labour with increased risk of a chronic rectovaginal fistula, incontinence and significant psychological morbidity. This case highlights the importance of routine PR examinations, early diagnosis and a MDT approach in order to achieve good outcomes A thorough, systematic examination of the perineum, rectum and vagina should be performed after all vaginal deliveries to ensure prompt recognition and management and in doing so mitigate the potentially serious medicolegal implications of a missed injury.en_US
dc.relation.ispartofconferencetitleAustralian and New Zealand Journal of Obstetrics and Gynaecologyen_US
dc.subject.fieldofresearchPaediatrics and Reproductive Medicineen_US
dc.subject.fieldofresearchPublic Health and Health Servicesen_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsObstetrics & Gynecologyen_US
dc.titleRare and Unusual Birth Trauma: A Case of an Extensive Buttonhole Tearen_US
dc.typeConference outputen_US
dc.type.descriptionE3 - Conferences (Extract Paper)en_US
dcterms.bibliographicCitationVan der Walt, R; Ellepola, H, Rare and Unusual Birth Trauma: A Case of an Extensive Buttonhole Tear, Australian and New Zealand Journal of Obstetrics and Gynaecology, 2021, 61, pp. 121-121en_US
gro.hasfulltextNo Full Text
gro.griffith.authorEllepola, Hasthika

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