Subject: Midwifery II (Theory)
When the time comes for an incision to be made in the perineum and the posterior vaginal wall during the second stage of labor, this procedure is known as an episiotomy. To help in labor, the vagina is enlarged with a surgical incision across the perineum. Episiotomy is performed to alleviate tension and pressure on the fetal head, to increase the vaginal aperture to help in smooth and safe childbirth, to reduce the risk of perineal muscle overstretch and rupture, and to prevent lacerations and tears. There are several reasons to choose for an episiotomy, including a difficult vaginal delivery, fetal distress, early birth, cord prolapse, or a very big baby. It's helpful because it prevents the perineum from being overstretched, shortens the second stage, and is simpler to heal than a lacerated wound.
An episiotomy is an incision made in the vaginal wall and perineum during the second stage of labor and delivery. With the goal of making vaginal birth easier, a surgical incision is created through the perineum.
The timing of the episiotomy requires discretion. Episiotomies involve cutting through the fourchette, superficial muscles, perineum skin, and posterior vaginal wall skin. The presenting component can only hasten delivery if it is inserted directly into these tissues. If done too quickly, blood loss from damaged vessels is possible and the presenting component will not be released. In the event that the surgery is carried out too late, tears and lacerations may develop. This means that the optimal time to crowing is just before the perineum begins to swell and thin.
Define episiotomy and its objectives?
Episiotomy
Objectives
What are the advantages and disadvantages of epissiotomy ?
Advantages
Maternal
Fetal
Disadvantage
What are the types of episiotomy ?
Types of Ppisiotomy
The incision is made downward and outward from the mid point of the fourchette either to the left or right. It is directed diagonally in a straight line which runs 2.5 cm away from the anus.
The incision commences from the centre of the flechette and extends posteriorly along the middle for about 2.5cm.
The incision starts from about 1 cm away from the center of the fourchette and extends laterally. It has got many drawbacks including a chance of injury to the Bartholin duct. It is totally condemned.
The incision begins in the center of the center of the fourchette and is directed posteriorly along the midline for about 1.5 cm and then directed downward and outward along 5or 7 o' clock position to avoid the anal sphincter. This is also not done widely.
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