Episiotomy: Difference between revisions
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== | == Description == | ||
An episiotomy is the most common obstetric surgical procedure performed in the second stage of [[Labour|labor]]. <ref>Langrová P, Vrublová Y. [https://www.researchgate.net/publication/286752379_Relationship_between_episiotomy_and_prevalence_of_urinary_incontinence_in_women_2-5_years_after_childbirth Relationship between episiotomy and prevalence of urinary incontinence in women 2-5 years after childbirth]. small. 2014;90:98.</ref>It is done to reduce the incidence of severe perineal tears (third and fourth-degree) during labor. A controlled incision is made in the perineum to enlarge the vaginal orifice, thereby facilitating a difficult delivery resulting in an easily repairable incision compared to an uncontrolled vaginal trauma. | |||
== | == Types of Episiotomy == | ||
== | == Indication == | ||
Episiotomy is suggested to be administered during difficult vaginal deliveries to control and avoid potentially perineal lacerations at the time of delivery. | |||
It is done in conditions such as<ref>Kartal B, Kızılırmak A, Calpbinici P, Demir G. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776158/#:~:text=Results%3A,and%2030.2%25%20in%20multipara%20women. Retrospective analysis of episiotomy prevalence.] Journal of the Turkish German Gynecological Association. 2017 Dec;18(4):190.</ref>: | |||
* complicated vaginal deliveries (breech, shoulder dystocia, forceps, vacuum), | |||
* incision-related scars in the genital area, | |||
* poorly healed or 4th degree tears, and fetal distress, | |||
Different opinions exists about the applicability of episiotomy: | |||
Benefits thought for the mother are:<ref name=":0">Izuka EO, Dim CC, Chigbu CO, Obiora-Izuka CE. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250993/ Prevalence and predictors of episiotomy among women at first birth in Enugu, south east Nigeria.] Annals of medical and health sciences research. 2014;4(6):928-32.</ref><ref name=":1">Carroli G. Mignini l. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175536/ Episiotomy for vaginal birth (Cochrane Review).] The Cochrane Collaboration and published in The Cochrane Library. 2009.</ref> | |||
* reduction in the likelihood of third degree perineal tears, | |||
* the preservation of the muscle relaxation of the pelvic floor and perineum leading to improved sexual function, | |||
* reduced risk of fecal and urinary incontinence, | |||
* ease of repair and better healing than laceration because it is a straight and clean incision | |||
Benefits for the baby: | |||
It is also suggested that episiotomy increases the APGAR score of the baby, reduces the prolonged second stage and may also reduce the possibility of fetal shoulder dystocia. In some cases, rigid perineum could lead to fetal asphyxia, cranial trauma, cerebral hemorrhage, and mental retardation.<ref name=":0" /><ref name=":1" /> | |||
== Complication == | |||
== Resources == | == Resources == | ||
Revision as of 10:38, 28 May 2022
Original Editor - User Name
Top Contributors - Vidya Acharya
Description[edit | edit source]
An episiotomy is the most common obstetric surgical procedure performed in the second stage of labor. [1]It is done to reduce the incidence of severe perineal tears (third and fourth-degree) during labor. A controlled incision is made in the perineum to enlarge the vaginal orifice, thereby facilitating a difficult delivery resulting in an easily repairable incision compared to an uncontrolled vaginal trauma.
Types of Episiotomy[edit | edit source]
Indication[edit | edit source]
Episiotomy is suggested to be administered during difficult vaginal deliveries to control and avoid potentially perineal lacerations at the time of delivery.
It is done in conditions such as[2]:
- complicated vaginal deliveries (breech, shoulder dystocia, forceps, vacuum),
- incision-related scars in the genital area,
- poorly healed or 4th degree tears, and fetal distress,
Different opinions exists about the applicability of episiotomy:
Benefits thought for the mother are:[3][4]
- reduction in the likelihood of third degree perineal tears,
- the preservation of the muscle relaxation of the pelvic floor and perineum leading to improved sexual function,
- reduced risk of fecal and urinary incontinence,
- ease of repair and better healing than laceration because it is a straight and clean incision
Benefits for the baby:
It is also suggested that episiotomy increases the APGAR score of the baby, reduces the prolonged second stage and may also reduce the possibility of fetal shoulder dystocia. In some cases, rigid perineum could lead to fetal asphyxia, cranial trauma, cerebral hemorrhage, and mental retardation.[3][4]
Complication[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ Langrová P, Vrublová Y. Relationship between episiotomy and prevalence of urinary incontinence in women 2-5 years after childbirth. small. 2014;90:98.
- ↑ Kartal B, Kızılırmak A, Calpbinici P, Demir G. Retrospective analysis of episiotomy prevalence. Journal of the Turkish German Gynecological Association. 2017 Dec;18(4):190.
- ↑ 3.0 3.1 Izuka EO, Dim CC, Chigbu CO, Obiora-Izuka CE. Prevalence and predictors of episiotomy among women at first birth in Enugu, south east Nigeria. Annals of medical and health sciences research. 2014;4(6):928-32.
- ↑ 4.0 4.1 Carroli G. Mignini l. Episiotomy for vaginal birth (Cochrane Review). The Cochrane Collaboration and published in The Cochrane Library. 2009.
