During the delivery, it is necessary to cut an episiotomy. The tear extends through the sphincter of the rectum, but the rectal mucosa is intact. How would you classify this type of episiotomy?

A first-degree tear involves the vaginal mucosa or perineal skin, but not the underlying tissue. In a second-degree episiotomy, the underlying subcutaneous tissue is also involved, but not the rectal sphincter or rectal mucosa. In a third-degree tear, the rectal sphincter is affected. A fouh-degree episiotomy involves a tear that extends into the rectal mucosa. Ref:Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 23. Forceps Delivery and Vacuum Extraction. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.