Medio-lateral episiotomy as baby crowns. An episiotomy /ɛˌpiːziːˈɔːtʌmiː/ is a surgical incision through the perineum made to enlarge the vagina and assist childbirth. The incision can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic and is sutured closed after delivery. It is one of the most common medical procedures performed on women, and although its routine use in childbirth has steadily declined in recent decades, it is still widely practiced in Latin America. Medio-lateral episiotomy illustration. ...
Medio-lateral episiotomy illustration. ...
The symbols of the International Phonetic Alphabet can be used to show pronounciation in English. ...
Surgery Surgery is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. ...
It has been suggested that Anogenital distance be merged into this article or section. ...
The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ...
The external genital organs of the female are collectively known as the vulva (plural vulvae, vulvas)[1] or genitalia feminina externa[2]. In common speech, the term vagina is often used improperly to refer to the vulva or female genitals generally, even though, strictly speaking, the vagina is a specific...
A local anesthetic is a drug that reversibly inhibits the propagation of signals along nerves. ...
It has been suggested that suture material be merged into this article or section. ...
Latin America consists of the countries of South America and some of North America (including Central America and some the islands of the Caribbean) whose inhabitants mostly speak Romance languages, although Native American languages are also spoken. ...
Uses
Many physicians use episiotomies because they believe that it will lessen perineal trauma, minimize postpartum pelvic floor dysfunction by reducing anal sphincter muscle damage, reduce the loss of blood at delivery, and protect against neonatal trauma. In many cases though, episiotomies cause all of these problems. Research has shown that natural tears typically are less severe. It has been suggested that Anogenital distance be merged into this article or section. ...
In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death. ...
Pelvic floor dysfunction is a group of clinical conditions that includes urinary incontinence, anal incontinence, pelvic organ prolapse, sensory and emptying abnormalities of the lower urinary tract, defecatory dysfunction, sexual dysfunction and several chronic pain syndromes, including vulvodynia. ...
Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ...
A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ...
Episiotomies may be indicated if:
- there is any sign of fetal distress while the baby is in the birth canal
- a delivery occurs too quickly for the vagina to stretch naturally
- the baby's head is too large for the opening
- the baby's shoulders are stuck (When a baby's shoulders are stuck they are stuck behind bony pelvis, not soft tissue, so this indication is disputed)
- it is a breech birth or forceps delivery
In medicine (obstetrics), fetal distress is the presence of signs in a pregnant woman—before or during childbirth—that the fetus is not well or is becoming excessively fatigued. ...
Human female internal reproductive anatomy The vagina (from the Latin for sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female mammals, or to the cloaca in female birds and some reptiles. ...
The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ...
Breech, by W.Smellie, 1792 A breech birth (also known as breech presentation) refers to the position of the baby in the uterus such that it will be delivered buttocks first as opposed to the normal head first position. ...
Controversy about common usage In various countries, routine episiotomy has been accepted medical practice for many years. Various urban legends circulate on the fact that after very rapid natural births, young doctors would still make episiotomies so as not to displease their professors. An urban legend or urban myth is similar to a modern folklore consisting of stories often thought to be factual by those circulating them. ...
Since about the 1960s, routine episiotomies are rapidly losing popularity among obstetricians and midwives in Europe, Australia and the United States. A nationwide US population study by Weber and Meyn (2002) suggested that 31% of women having babies in U.S. hospitals received episiotomies in 1997, compared with 56% in 1979. In Latin America it's still popular, where it's done on 90% of hospital births [1] and in most cases without the mother's consent. There, routine episiotomy is a major cause of infections, some of them fatal [2] . The 1960s decade refers to the years from January 1, 1960 to December 31, 1969, inclusive. ...
This article needs cleanup. ...
Midwifery is a blanket term used to describe a number of different types of health practitioners, other than doctors, who provide prenatal care to expecting mothers, attend the birth of the infant and provide postnatal care to the mother and infant. ...
Year 1997 (MCMXCVII) was a common year starting on Wednesday (link will display full 1997 Gregorian calendar). ...
Also: 1979 by Smashing Pumpkins. ...
Latin America consists of the countries of South America and some of North America (including Central America and some the islands of the Caribbean) whose inhabitants mostly speak Romance languages, although Native American languages are also spoken. ...
Recent studies indicate that routine episiotomies should not be performed, as they may increase morbidity. Hartmann et al (2005), reviewing the literature, indicate that this procedure is not helpful for routine patients, though there are certain instances, such as a narrow birth canal and other problems as described above. In medicine, epidemiology and actuarial science, the term morbidity can refer to the state of being diseased (from Latin morbidus: sick, unhealthy), the degree or severity of a disease, the prevalence of a disease: the total number of cases in a particular population at a particular point in time, the...
Having an episiotomy may increase perineal pain in the postpartum period, resulting in trouble defecating (particularly in midline episiotomies, as demonstrated by Signorello et al 2000). In addition it may complicate sexual intercourse by making it painful [3] and replacing erectile tissues in the vulva with fibrotic tissue. Postnatal (Latin for after birth) is the period beginning immediately after the birth of a child and extending for about six weeks. ...
This article or section does not cite its references or sources. ...
It has been suggested that Duration of sexual intercourse be merged into this article or section. ...
Erectile tissue is tissue in the body that can become erect, usually by becoming engorged with blood. ...
It has been said by some that an intact perineum serves to perform a Heimlich maneuver style move on a baby born in the normal head-first orientation. This is thought by some to expel fluid from the baby's lungs[citation needed]. The Heimlich maneuver The Heimlich maneuver, also known as abdominal thrusts, is a first aid procedure for clearing an obstructed airway. ...
In cases where an episiotomy is indicated a mediolateral incision may be preferable to a median (midline) incision as the latter is associated with a higher risk of injury to the anal sphincter and the rectum. (ACOG Practice Bulletin).
Informed consent Expectant mothers frequently make "birth plans" during their antenatal care, and are generally encouraged to discuss their views on episiotomy with their carers, or as early as possible in labour. In the final stages of delivery the midwife or obstetrician may not have time to discuss the benefits, risks and alternatives without endangering the mother or baby. However, staff restrictions or complications in labour often mean that these plans have to be altered in the course of the birth. This article needs cleanup. ...
Midwifery is a blanket term used to describe a number of different types of health practitioners, other than doctors, who provide prenatal care to expecting mothers, attend the birth of the infant and provide postnatal care to the mother and infant. ...
This article needs cleanup. ...
Avoidance Perineal massage beginning around the 34th week has been shown to reduce perineal damage by 6% (Shipman MK. Antenatal perineal massage and subsequent perineal outcomes: A Randomized trial. BrJObGyn 1997;104:787. Perineal massage is the practice of massaging the perineum to make it more flexible in preparation for childbirth. ...
Controlled delivery of the head that allows slow gradual stretching of the perineal tissue can help in minimising damage to the perineum. Episiotomy is almost never required. If the tissue is stretching, some studies suggest that small natural tears heal quicker and are less painful, so a tear is preferrable to an episiotomy.
There are also devices which are made to stretch the perineal tissue gradually to train it in preparation for birth. One example is the "epi-no", which consists of an inflatable balloon pumped with the same pump as a sphygmomanometer. Epi-no device has been shown to reduce perineal damage by 50% at first births. (Cohain JS 2004. Perineal Outcomes after practicing with a Perineal Dilator. MIDIRS Midwifery Digest 14:37-41. http://www.epi-no.com/pdf_downloads/experience_judy_slome.pdf) BP 126/70 mmHg as result on electronic sphygmomanometer A sphygmomanometer (often condensed to sphygmometer[1]) or blood pressure meter is a device used to measure blood pressure, comprising an inflatable cuff to restrict blood flow, and a mercury or mechanical manometer to measure the pressure. ...
References - Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA 2005;293:2141-8. PMID 15870418.
- Signorello LB, Harlow BL, Chekos AK, Repke JT. Midline episiotomy and anal incontinence: retrospective cohort study. BMJ 2000;320:86-90. PMID 10625261.
- Weber AM, Meyn L. Episiotomy use in the United States, 1979-1997. Obstet Gynecol 2002;100:1177-82. PMID 12468160.
- Episiotomy. ACOG Practice Bulletin No.71. American College of Obstericians and Gynecologists. Obstet Gynecol 2006;107:957-62.
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Systematic reviews are named as the highest level of medical evidence, by evidence based medicine professionals. ...
JAMA, published continuously since in 1883, is an international peer-reviewed general medical journal published 48 times per year. ...
The British Medical Journal (BMJ) is a medical journal published weekly in the United Kingdom by the British Medical Association (BMA). ...
The American College of Obstetricians and Gynecologists (ACOG) is a professional association of medical doctors specializing in obstetrics and gynecology in the United States. ...
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