L1: Episiotomy

Question 1

Def of Episiotomy

Answer 1

Operation in which perineum is incised during labor to widen vaginal orifice.

Question 2

Indications of Episiotomy

Answer 2

Question 3

Indications of Episiotomy

• Maternal

Answer 3

Question 4

Advantages of Episiotomy

Answer 4

Question 5

Indications of Episiotomy

• Fetal

Answer 5

Question 6

Types of Episiotomy

Answer 6

A. Median episiotomy.
B. Mediolateral episiotomy.
C. J-shaped episiotomy.

Question 7

Technique of Median Episiotomy

Answer 7

Incision is done in midline of perineum.

Question 8

Structures Divided in Median Episiotomy

Answer 8

• Vaginal mucosa & fourchette.
• Perineal skin & fascia.
• Perineal body.

Question 9

Disadvantages of Median Episiotomy

Answer 9

May extend to involve anal sphincter.

Question 10

Advantages of Median Episiotomy

Answer 10

• Easy.
• Less bleeding.
• Repair is easy & anatomical (less discomfort, dyspareunia).

Question 11

Technique of Mediolateral Episiotomy

Answer 11

• Incision starts at fourchette then extends towards ischial tuberosity.

Question 12

Structures Divided in Mediolateral Episiotomy

Answer 12

• Vaginal mucosa & fourchette.
• Perineal skin & fascia.
• Superficial & deep transverse perineal muscles.
• Bulbocavernosus muscle.
• Pubovaginalis muscle

Question 13

Advantages of Mediolateral Episiotomy

Answer 13

Avoid extension to anal sphincter.

Question 14

Disadvantages of Mediolateral Episiotomy

Answer 14

1. More difficult.
2. More bleeding.
3. Repair is difficult & not anatomical (more painful scar).

Question 15

Technique of J-Shaped Episiolotomy

Answer 15

Incision starts as midline episiotomy to within 2 cm from anal sphincter then extends laterally

Question 16

Steps of Episiotomy

Answer 16

Question 17

After Care of Episiotomy

Answer 17