Perineal management Flashcards
1
Q
Risk factors for perineal management
A
- primiparity
- operative delivery
- upright delivery
- prolonged second stage
- OP position
- BMI
- history of perineal trauma
2
Q
Role of the midwife in reducing perineal trauma risk during birth
A
2
Q
Evidence based risk reduction strategies
A
- slow controlled birth
- perineal warm complex
- episiotomy technique
- appropriate detection and suturing of tears
3
Q
Role of the midwife during infiltration and episiotomy
A
4
Q
Indications for episiotomy
A
5
Q
Assessment of genital tract trauma
A
- good lighting
- pain relief
- sterile gloves
- clean with saline
- rectal exam
6
Q
Management of genital tract trauma
A
- analgesia
- suturing required for 2nd degree and above
- sometimes first degree tears do not require suturing unless they are bilateral (so that they don’t fuse together)
7
Q
Classification of genital tract trauma
A
degree 1- injury to perineum and surrounding skin
degree 2 - injury to perineum and perineal muscles
degree 3 - injury to perineum, perineal muscles and anal sphincter complex
a <50% external sphincter
b >50% external sphincter
c Internal and external sphincter
degree 4 - injury extending from perineum through entire anal sphincter to rectum
