Case notes
A 33-year-old pregnant woman (gravida 2, para 1) was referred because she sustained vaginal wall rupture during home birth. Her first delivery was complicated by a third-degree perineal tear from which she fully recovered after surgery. During transfer in the ambulance, she delivered an 8.6 lb (3.9 kg) male infant. On admission to our hospital, a complex rupture was evident ( Figure 1 ).
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Conclusions
Inspection under general anesthesia confirmed the diagnosis of a paravaginal birth with a lateral and posterior vaginal wall defect ( Figure 2 ). Delivery of the placenta was performed by the same route, bypassing the vaginal introitus ( Video ). The vaginal wall, labial rupture, and a third-degree perineal tear were sutured ( Figures 3 and 4 ). At the 6-week follow-up visit, the tears were fully healed. Our patient still experienced some numbness in the perineal area, but she had no pain and no urinary or fecal incontinence.
