Postpartum perineal care and management of complications
- Lori R Berkowitz, MD
Lori R Berkowitz, MD
- Assistant Professor
- Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- Caroline E Foust-Wright, MD, MBA
Caroline E Foust-Wright, MD, MBA
- Assistant Professor of Urology/Obstetrics and Gynecology
- Tufts School of Medicine
- Section Editors
- Linda Brubaker, MD, FACOG
Linda Brubaker, MD, FACOG
- Section Editor — Female Pelvic Medicine and Reconstructive Surgery
- Health Sciences Clinical Professor
- University of California, San Diego
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
This topic presents information on routine postpartum perineal care as well as evaluation and management of delivery-related perineal complications. Despite the importance of postpartum perineal care, there is little evidence to guide management; the information in this topic is based largely on our clinical experience.
In our experience, common postpartum perineal issues include pain control, hygiene, prevention of constipation, and resumption of sexual activity. Clinicians should be able to evaluate less common symptoms, such as severe pain, bulge or mass, or abnormal discharge, including fecal leakage.
Related topics that are presented separately include:
- American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Association of Women’s Health, Obstetric and Neonatal Nurses. Committee Opinion No. 666: Optimizing Postpartum Care. Obstet Gynecol 2016; 127:e187.
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- INITIAL APPROACH
- Pain management
- Constipation prevention
- Resumption of sexual activity
- SYMPTOMS REQUIRING EVALUATION
- Severe pain
- - Infection
- - Separation
- Bulge or mass
- - Hematoma
- Abnormal discharge
- PHYSICAL EXAMINATION
- POST-DISCHARGE CARE
- LONG-TERM ISSUES
- Perineal pain or dyspareunia
- Incontinence or pelvic organ prolapse
- SPECIAL POPULATIONS
- Obstetric anal sphincter injury
- Female genital cutting (circumcision)
- SUMMARY AND RECOMMENDATIONS