Perinial trauma and episiotomy

Question 1

What is an anterior perinial trauma?

Answer 1

Any Injury to the labia, anterior vagina, urethra, or clitoris. (Chris kettle, 2010, Myles)

Question 2

What is posterior perineal trauma?

Answer 2

Any Injury to the posterior vaginal wall, perineal muscles, or anal sphincters (external and internal ) and may include disruption of the rectal mucosa.

Question 3

What is the prevalence of perineal trauma?

Answer 3

Over 85% of women who have vaginal birth will sustain some form of perineal trauma.

Question 4

Name four risk factors that can be associated with and reference?

Answer 4

Parity

Size of baby

Mode of delivery

Malpresentatioon and malposition of fetus

Ethnicity

age
(Groutz et al. 2011)

Question 5

how would you prepare a woman, antenatally to avoid perineal trauma during birth.

Answer 5

encourage perineal massage

encourage pelvic floor exercise, that will stretch the pelvic floor to prevent trauma or episiotomy

Question 6

What the NICE 2014 definition of a first degree tear?

Answer 6

first degree – injury to skin only

Question 7

What the NICE 2014 definition of a second degree tear?

Answer 7

second degree – injury to the perineal muscles but not the anal sphincter

Question 8

What the NICE 2014 definition of a third (A,B,C) degree tear?

Answer 8

third degree – injury to the perineum involving the anal sphincter complex:

3a – less than 50% of external anal sphincter thickness torn

3b – more than 50% of external anal sphincter thickness torn

3c – internal anal sphincter torn.

Question 9

What the NICE 2014 definition of a fourth degree tear?

Answer 9

fourth degree – injury to the perineum involving the anal sphincter complex (external and internal anal sphincter) and anal epithelium.

Question 10

What is the definition of an episiotomy?

Answer 10

A surgical incision of the perineum made to increase the diameter of the vulval out let during birth (Chris Kettle, 2010 mayes)

Question 11

Name the reasons as to why an episiotomy would occur?

Answer 11

Rigid perineum causing a delay in second stage

reduce prolonged maternal pushing, if she was to have a severe hypertensive or cardiac disease.

Fetal compromise

prevent severe perinieal trauma during instrumental delivery or if baby is OP

Question 12

Name the risks that could come with an episiotomy?

Answer 12

could increase posterior perineal trauma

increases intrapartum blood loss

increased postpartum pain and perineal infection

potential reduction in pelvic floor muscle function