Episiotomy
An episiotomy is a surgical intervention performed during the second stage of labor and delivery, where an incision is made in the perineum -- the area between the vagina and anus -- to enlarge the vaginal opening for the delivery of the baby.[1] The procedure is designed to prevent severe perineal tears that can occur during childbirth.
Procedure
An episiotomy is typically performed as the baby's head is stretching the vaginal opening, just before delivery. After administering local anesthesia to numb the area, the doctor makes a small incision in the perineum. There are two main types of episiotomy:
- Midline episiotomy: The incision is made vertically from the vaginal opening straight towards the anus.
- Mediolateral episiotomy: The incision is made at an angle from the vaginal opening. This type is less likely to extend to the anus but can result in more pain during the recovery period and possible complications for sexual function.[2]
Indications
The routine use of episiotomy during childbirth has been widely debated in the medical community. However, it may be performed in the following circumstances:
- When extensive vaginal tearing appears likely
- During a prolonged delivery that puts stress on the baby
- When forceps or a vacuum device is used for delivery
- When there is a medical need to speed up delivery[3]
Risks and Complications
Despite its intended benefits, an episiotomy can lead to several complications:
- Increased blood loss
- More extensive perineal pain during recovery
- Risk of infection
- Possible complications with future vaginal deliveries
- Difficulties with sexual intercourse post-delivery[4]
Recovery and Aftercare
The incision site is usually stitched up after the delivery of the baby and placenta. Pain management, hygiene of the wound area, and monitoring for signs of infection are crucial components of aftercare. Pelvic floor exercises may aid in the recovery process.[5]
Current Practice and Recommendations
The routine use of episiotomy has been discouraged in recent years by several health organizations, including the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG). They recommend that the procedure should only be performed when it's absolutely necessary, considering the potential risks and complications. Evidence has suggested that restrictive use of episiotomy can lead to less postpartum pain and fewer complications than when the procedure is done routinely.[6]
See Also
References
- ↑ Carroli, G, Episiotomy for vaginal birth, Cochrane Database of Systematic Reviews, 2009, DOI: 10.1002/14651858.CD000081.pub2,
- ↑ Eason, E, Mediolateral episiotomy reduces the risk for anal sphincter injury during operative vaginal delivery, BJOG: An International Journal of Obstetrics & Gynaecology, 2005, Vol. 112(Issue: 1), pp. 106–110, DOI: 10.1111/j.1471-0528.2004.00312.x,
- ↑ Hartmann, K, Outcomes of routine episiotomy: a systematic review, JAMA, 2005, Vol. 293(Issue: 17), pp. 2141-2148, DOI: 10.1001/jama.293.17.2141,
- ↑ Suto, M, Episiotomy and perineal repair - its practice in Japanese university hospitals, Journal of Obstetrics and Gynaecology Research, 2000, Vol. 26(Issue: 1), pp. 43–47, DOI: 10.1111/j.1447-0756.2000.tb01273.x,
- ↑ Kindberg, S, Prediction and prevention of obstetric anal sphincter injuries, Current Opinion in Obstetrics & Gynecology, 2008, Vol. 20(Issue: 5), pp. 519–523, DOI: 10.1097/GCO.0b013e32830def5d,
- ↑ Jiang, H, Selective versus routine use of episiotomy for vaginal birth, Cochrane Database of Systematic Reviews, 2017, DOI: 10.1002/14651858.CD000081.pub3,
Transform your life with W8MD's budget GLP-1 injections from $125.
W8MD offers a medical weight loss program to lose weight in Philadelphia. Our physician-supervised medical weight loss provides:
- Most insurances accepted or discounted self-pay rates. We will obtain insurance prior authorizations if needed.
- Generic GLP1 weight loss injections from $125 for the starting dose.
- Also offer prescription weight loss medications including Phentermine, Qsymia, Diethylpropion, Contrave etc.
NYC weight loss doctor appointments
Start your NYC weight loss journey today at our NYC medical weight loss and Philadelphia medical weight loss clinics.
- Call 718-946-5500 to lose weight in NYC or for medical weight loss in Philadelphia 215-676-2334.
- Tags:NYC medical weight loss, Philadelphia lose weight Zepbound NYC, Budget GLP1 weight loss injections, Wegovy Philadelphia, Wegovy NYC, Philadelphia medical weight loss, Brookly weight loss and Wegovy NYC
|
WikiMD's Wellness Encyclopedia |
| Let Food Be Thy Medicine Medicine Thy Food - Hippocrates |
Medical Disclaimer: WikiMD is not a substitute for professional medical advice. The information on WikiMD is provided as an information resource only, may be incorrect, outdated or misleading, and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. WikiMD expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site. By visiting this site you agree to the foregoing terms and conditions, which may from time to time be changed or supplemented by WikiMD. If you do not agree to the foregoing terms and conditions, you should not enter or use this site. See full disclaimer.
Credits:Most images are courtesy of Wikimedia commons, and templates, categories Wikipedia, licensed under CC BY SA or similar.
Contributors: Prab R. Tumpati, MD
