[44] Episiotomy Flashcards
What is an episiotomy?
A surgical incision of the perineum and posterior vaginal wall performed by midwife or obstetrician
When is an episiotomy performed?
In the 2nd stage of labour?
Why is an episiotomy performed?
To quickly enlarge the opening for the baby to pass through
What was the rate of episiotomy in 2010-11?
15%
How many main types of episiotomy are there?
4
What are the 4 main types of episiotomy?
- Mediolateral
- Median
- Lateral
- J-shaped
What is a mediolateral episiotomy?
Incision is made down and out from the midpoint of the fourchette and directed diagonally in a straight line for 2.5cm
What is a median episiotomy?
Incision comes from centre of fourchette and down the midline for 2.5cm
What is a lateral episiotomy?
A no recommended episiotomy due to risk of injury to Bartholin’s duct
What is a J-shaped episiotomy?
Down from centre of fourchette along the midline for 1.5cm then downwards and outwards along 5/7 o’clock position
Is the J-shaped episiotomy widely used?
No
How should the patient be prepared for episiotomy?
- If not an adequate epidural infiltrate perineum with local anaesthetic
- If good epidural top up with patient upright
What is the usually recommended episiotomy method?
Mediolateral
What are the indications for episiotomy?
- Delay due to rigid peritoneum
- When tear seems imminent and episiotomy is preferable
- Instrumental delivery
Why is an episiotomy used when there is delay due to rigid peritoneum?
Cutting may expedite delivery
