Perineal tear — DRCOG MCQ

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A 28-year-old woman after vaginal birth has a tear involving the external anal sphincter. What is the most likely diagnosis?

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Correct answer: D — Third-degree perineal tear

Third-degree perineal tear is the best answer because the vignette is testing Perineal tear and the recommended approach is consistent with RCOG Green-top Guideline 29. The other diagnoses do not explain the combination of timing, examination findings and investigation results as well as the correct diagnosis. Specifically, Discuss elective induction next week; Physiological neonatal jaundice; Arrange routine antenatal clinic review; Chlamydia infection would be suboptimal in this scenario. The key discriminator is the pattern across symptoms, examination and timing, not a single isolated symptom.

Reference: RCOG Green-top Guideline 29