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Third and Fourth Degree Perineal Tears Clinical Care Standard: 4c-Proportion of women who had a vaginal birth who sustained a Grade 3b perineal tear

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this term4c-Proportion of women who had a vaginal birth who sustained a Grade 3b perineal tear
METeOR identifier:Help on this term728510
Registration status:Help on this termAustralian Commission on Safety and Quality in Health Care, Standard 20/04/2021
Description:Help on this term

The proportion of women who had a vaginal birth who sustained a Grade 3b perineal tear.

Indicator set:Help on this termClinical care standard indicators: Third and Fourth Degree Perineal Tears Australian Commission on Safety and Quality in Health Care, Standard 20/04/2021

Collection and usage attributes

Population group age from:Help on this term

18 yrs or older

Computation description:Help on this term

The degree of perineal injury should be classified using the Royal College of Obstetricians and Gynaecologists (RCOG) classification of perineal tears.   

RCOG classification of perineal tears

Degree of perineal tear Grade Description
First degree    Injury to perineal skin and/or vaginal mucosa
Second degree    Injury to perineum involving perineal muscles but not involving the anal sphincter
Third degree    Injury to perineum involving the anal sphincter complex
  3a Less than 50% of external anal sphincter(EAS) thickness torn
  3b More than 50% of EAS thickness torn
  3c Both EAS and internal anal sphincter (IAS) torn
Fourth degree   Injury to perineum involving the anal sphincter complex (EAS and IAS) and anorectal mucosa.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ Denominator) x 100‚Äč

Numerator:Help on this term

Number of women who sustained a grade 3b perineal tear.

Denominator:Help on this term

The number of women who had a vaginal birth.

Include separations where an outcome of delivery was record using the ICD codes in Table A, and a caesarean delivery was not recorded (Table B).

Table A: ICD-10-AM codes for delivery outcome

Code Description

Z37.0   

Single live birth
Z37.1 Single stillbirth
Z37.2 Twins, both liveborn
Z37.3 Twins, one liveborn and one stillborn
Z37.4 Twins, both stillborn
Z37.5 Other multiple births, all liveborn
Z37.6 Other multiple births, some liveborn
Z37.7 Other multiple births, all stillborn
Z37.9   Outcome of delivery, unspecified

Table B: ACHI codes for caesarean section

Code Description
16520-00

Elective classical caesarean section

16520-01 Emergency classical caesarean section
16520-02 Elective lower segment caesarean section
16520-03 Emergency lower segment caesarean section
16520-04 Elective caesarean section, not elsewhere classified
16520-05 Emergency caesarean section, not elsewhere classified

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

Australian Commission on Safety and Quality in Health Care 2021. Third and Fourth Degree Perineal Tears clinical care standard. Australian Commission on Safety and Quality in Health Care, Sydney.

Royal College of Obstetricians and Gynaecologists 2015. The management of third- and fourth-degree perineal tears (Green top 29). Royal College of Obstetricians and Gynaecologists, London.

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