Anal sphincter tear may be suspected post-delivery
when the perineal body or vaginal epithelium is torn.
Such an injury is clinically detected in 1.5–9% of
vaginal deliveries.18 However, a normal perineum on
clinical examination does not exclude underlying
sphincter damage. The incidence of sphincter damage
increases significantly when an episiotomy scar is
associated with a perineal tear.19 Misdiagnosis immediately
post-delivery can occur because of blood and
tissue edema, and a lack of training in the clinical
identification of muscle tears.20 Therefore, the more
experienced the clinician, the less likely that an injury
will be missed.1