1. First-degree perineal laceration: injury to only the vaginal epithelium or perineal skin. 2. Second-degree laceration: injury to perineum that spares.

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1. First-degree perineal laceration: injury to only the vaginal epithelium or perineal skin. 2. Second-degree laceration: injury to perineum that spares the anal sphincter complex but involves the perineal muscles, which are the bulbospongiosus and superficial transverse perineal muscles. 3a. Third-degree laceration: <50 percent of the external anal sphincter (EAS) is torn. 3b. Third-degree laceration: >50 percent of the EAS is torn, but the internal anal sphincter (IAS) remains intact. 3c. Third-degree laceration: EAS and IAS are torn. 4. Fourth-degree laceration: the perineal body, entire anal sphincter complex, and anorectal mucosa are lacerated. (Reproduced with permission from Kenton K, Mueller M: Episiotomy and obstetric anal sphincter lacerations. In Yeomans ER, Hoffman BL, Gilstrap LC III, et al (eds): Cunningham and Gilstrap’s Operative Obstetrics, 3rd ed. New York, McGraw-Hill Education, 2017.) Source: Vaginal Delivery, Williams Obstetrics, 25e Citation: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Williams Obstetrics, 25e; 2016 Available at: https://obgyn.mhmedical.com/DownloadImage.aspx?image=/data/books/1918/cunnwo25-ch027_f013.png&sec=150960240&BookID=1918&ChapterSecID=150960110&imagename= Accessed: October 18, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved