What is Episiotomy, indication, type, selection of incision ~ Medical diseases and trems ,symptoms causes TREATMENT

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What is Episiotomy, indication, type, selection of incision

 


DEFINITION 

      It also known as periniotomy. It is wildling of birth canal. It is 2°perineal injury. 

PERINEAL INJURY 

     A. 1° Skin .

     B. 2° Skin + Muscles + Vaginal mucosa .

     C. 3° 2° + Anus   External and internal spinture .

     D. 4° 3° +Rectal mucosa .

INDICATION 

    ☆ Primipera .

    ☆ History of previous Episiotomy.

    ☆ Precipitated Labour. 

    ☆ Rigid perineum. 

TIMING 

Just before the crowning. 

ADVANTAGE 

It prevent unwanted rupture. 

TYPE 

1. MEDIAL 

                     It is second common type.it Involves in risk of muscles damage. ( 2.5 to 3 cm medial to porchetta)

2. Lateral 

                 It start 1cm lateral to porchetta. It involves risk of Bartholin duct damage. 

3. MEDIOLATERAL 

●  It is most common type. 

● Modified 'J' shape 

● Incision about 2.5cm to 3cm also known as 5 o'clock and 7 o'clock. 

● Common side is right side. 

PROCEDURE 

 General intervention involves, 

 ☆ Lithotomy position. 

 ☆ PERINEAL care. 

 ☆ Local Anastasia.

SELECTION OF INCISION 

● Incision is deep in nature also known as triple layer cutting. 

● Suture are both absorbent and non absorbent. 

MANAGMENT 

● Perineal care 

● Instruct the mother for ambulation after 24 hours of delivery. 

● Suture removal time 5 to 6 day after procedure. 

COMPLICATION 

Pain ,bleeding, Incision extended, painful sexual intercourse. 


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