Sulcal Laceration During Delivery – ICD-10 Codes, Definition, Location, Repair, and Bilateral Sulcus Laceration Images

Content:

• What is Sulcal Laceration During Delivery?
• Sulcal Laceration During Delivery ICD-10 Codes
• Sulcal Laceration During Delivery Definition
• Sulcal Laceration During Delivery Location
• Sulcal Laceration During Delivery Repair
• Bilateral Sulcus Laceration
• Sulcal Laceration During Delivery Images

What is Sulcal Laceration During Delivery?

A sulcal laceration during delivery is a type of soft tissue injury that occurs in the groove, or "sulcus", between the vaginal wall and the cervix during childbirth. These tears are usually the result of intense pressure, rapid delivery, or complications during labor. While less common than perineal or cervical lacerations, sulcal lacerations can lead to significant bleeding and may be difficult to detect immediately after delivery, making careful postpartum examination crucial. Sulcal lacerations may vary in severity, from superficial tears to deeper lacerations involving surrounding tissues. Proper identification is essential, as undiagnosed sulcal lacerations can result in postpartum hemorrhage or infection. Obstetricians typically examine the vaginal sulcus thoroughly in the delivery room to ensure no hidden injuries are missed. Early diagnosis and prompt suturing or repair are critical to ensure a smooth recovery and to prevent long-term complications for the mother.

Sulcal Laceration During Delivery Images

Images of sulcal lacerations during delivery are typically used in medical training and may not be widely available to the public due to the sensitive and graphic nature of the content. However, medical textbooks, surgical guides, and obstetric training videos often include illustrations or intraoperative photos that help healthcare providers recognize and treat these tears. These visuals are valuable tools in teaching proper diagnosis and repair techniques. If you're a medical student or practitioner, you may find sulcal laceration images through anatomy atlases, OB-GYN reference materials, or hospital training modules. For non-clinicians, it's important to understand that such images are graphic in nature and intended for educational purposes. If you're a patient, your provider can offer diagrams or explanations during postpartum checkups to help you understand the condition better if you experienced it during childbirth.

Sulcal Laceration During Delivery ICD-10 Codes

The correct ICD-10 coding for sulcal lacerations during delivery is important for medical documentation, insurance billing, and accurate medical recordkeeping. Although there isn't a dedicated ICD-10 code that specifically says "sulcal laceration," the general code used is **O70.3** – which refers to "Third-degree perineal laceration during delivery" or **O70.9**, "Perineal laceration, unspecified degree." If documented clearly, providers might use **O71.7**, which refers to other obstetric trauma. For more detailed medical coding, ICD-10-PCS may also be used when the laceration requires surgical repair. In that case, codes vary based on whether the procedure is open or involves suturing of soft tissues. It's essential to document whether the sulcal tear is left, right, or bilateral, and how it was treated. Medical coders often refer to the physician’s operative report or delivery note to assign the most accurate code.

Sulcal Laceration During Delivery Definition

A sulcal laceration is defined as a tear or rupture in the lateral vaginal fornix or sulcus area, which is located between the cervix and the vaginal wall. During childbirth, this region can be stretched or torn due to the pressure of the descending fetus, forceps delivery, or rapid expulsion of the baby. It differs from other types of birth-related tears like labial or perineal tears because it occurs deeper inside the birth canal. The laceration is often not visible externally and may not be identified unless there is notable bleeding or a specific examination is performed. It can be unilateral or bilateral, meaning it can occur on one or both sides of the vaginal canal. The key difference between a sulcal and perineal laceration is the anatomical location. Awareness of sulcal lacerations has grown in modern obstetrics because of their hidden nature and potential to cause significant blood loss if missed.

Sulcal Laceration During Delivery Location

Sulcal lacerations occur deep inside the vaginal canal, typically in the lateral sulcus. This is the groove that lies between the cervix and the lateral vaginal walls. Because of their internal location, sulcal tears are often difficult to detect through routine inspection after delivery. These lacerations are most often discovered when a patient continues to bleed despite repair of obvious external or perineal tears. They can happen on the left, right, or both sides of the vagina, and their detection requires a careful bimanual or speculum examination. Obstetricians will often use a lighted speculum to look for bleeding from deep within the vaginal vault. Their proximity to major blood vessels makes them more likely to cause heavy bleeding compared to superficial lacerations. Proper identification and treatment depend on awareness of this anatomical location.

Sulcal Laceration During Delivery Repair

Repairing a sulcal laceration usually involves suturing the torn tissue in layers using absorbable surgical sutures. The procedure is typically done under adequate anesthesia or analgesia shortly after delivery. Given the deep location of the sulcus, the repair can be challenging and may require assistance, good lighting, and sometimes additional tools like retractors or vaginal packs. If the sulcal laceration is deep or bleeds profusely, the repair must be done meticulously to prevent postpartum hemorrhage or hematoma formation. In cases of extensive tearing or bilateral sulcal lacerations, the mother may need to be taken to the operating room for a more controlled repair. Antibiotics are sometimes prescribed post-repair to prevent infection, and follow-up is important to ensure proper healing and tissue alignment.

Bilateral Sulcus Laceration

Bilateral sulcus lacerations refer to tears occurring on both the left and right lateral vaginal sulci. These types of injuries are less common than unilateral tears but are more complex due to the involvement of both sides. They may result from precipitous labor, large babies, or assisted delivery using tools like forceps. Because both sulci are affected, bilateral tears are more likely to cause heavy bleeding and may require extensive suturing. Clinically, bilateral sulcal lacerations may present with persistent vaginal bleeding after delivery, even when the perineum appears intact. This is why a thorough vaginal exam is essential. These tears require careful surgical management and close postpartum observation. Women with bilateral sulcus lacerations might also experience more discomfort during recovery due to the broader area of trauma and healing tissues.