Episotomy And Labor

Question 1

Episotomy

Answer 1

surgical incision of the perineum.

Question 2

Indications for episotomy

Answer 2

• instrumental delivery (vacuum and forceps
  *rigid perineum
  *scared perineum
• shoulder dystocia
  *Applied selectively for breech presentation
• should be done only necessary

Question 3

Timing of episiotomy

Answer 3

• Done at crowning during a contraction.

Question 4

Epistomy procedure

Answer 4

• clean the area with antiseptic solution
• infiltrate beneath the vaginal mucosa, beneath the skin and deeply into the perineal muscles using 10mls of 0.5% lignocaine
• check at the incision site for effect of local anesthesia by pinching with the forceps before giving incision
• perform episiotomy at crowning
• place two fingers beneath the baby’s head and the perineum and cut 3-4cm in mediolateral direction, starting from the midline
• after delivery of the baby and placenta carefully examine for extension or tears
• repair the episiotomy with vicryl 2-0 suture. Close the vaginal mucosa with continuous suture starting 1cm above the apex.
• Perineal muscles are approximated using interrupted sutures. Skin is closed with subcuticular (or interrupted) sutures.

Question 5

Care of episiotomy

Answer 5

*Perineal hygiene: clean the area with antiseptic solution after urination and defecation
* Analgesics are prescribed for pain relief

Question 6

Definition of labor

Answer 6

*Series of changes that take place in the genital organs in effort to expel the viable fetus from the womb to the outside world through the vaginal
*labor begins when there are uterine contractions of sufficient,intensity and duration to cause progressive effacement and dilatation of the cervix

Question 7

Normal labor

Answer 7

labour is defined as the act of expulsion of the fetus and placenta to the outside world per vaginam with minimal risk to the mother and fetus.Itischaracterisedbytheonsetofpainful, palpable and regular uterine contractions of progressively increasing frequency and intensity and associated with progressively increasing cervical effacement and cervical os dilatation and descent of the presenting part leading to the delivery of the fetus and placenta per vaginam with minimal disturbance to both mother and baby.