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Flashcards in Episiotomy Deck (18)
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1
Q

What is an episiotomy?

A

A surgical incision of the perineum and posterior vaginal wall performed by midwife or obstetrician

2
Q

When is an episiotomy performed?

A

In the 2nd stage of labour?

3
Q

Why is an episiotomy performed?

A

To quickly enlarge the opening for the baby to pass through

4
Q

What was the rate of episiotomy in 2010-11?

A

15%

5
Q

How many main types of episiotomy are there?

A

4

6
Q

What are the 4 main types of episiotomy?

A
  • Mediolateral
  • Median
  • Lateral
  • J-shaped
7
Q

What is a mediolateral episiotomy?

A

Incision is made down and out from the midpoint of the fourchette and directed diagonally in a straight line for 2.5cm

8
Q

What is a median episiotomy?

A

Incision comes from centre of fourchette and down the midline for 2.5cm

9
Q

What is a lateral episiotomy?

A

A no recommended episiotomy due to risk of injury to Bartholin’s duct

10
Q

What is a J-shaped episiotomy?

A

Down from centre of fourchette along the midline for 1.5cm then downwards and outwards along 5/7 o’clock position

11
Q

Is the J-shaped episiotomy widely used?

A

No

12
Q

How should the patient be prepared for episiotomy?

A
  • If not an adequate epidural infiltrate perineum with local anaesthetic
  • If good epidural top up with patient upright
13
Q

What is the usually recommended episiotomy method?

A

Mediolateral

14
Q

What are the indications for episiotomy?

A
  • Delay due to rigid peritoneum
  • When tear seems imminent and episiotomy is preferable
  • Instrumental delivery
15
Q

Why is an episiotomy used when there is delay due to rigid peritoneum?

A

Cutting may expedite delivery

16
Q

Why is episiotomy preferable in an instrumental delivery?

A

Forceps are very likely to cause a tear

17
Q

Is a routine episiotomy recommended?

A

No they don’t confer benefit

18
Q

When is there a benefit of performing episiotomy?

A

When it reduces the risk of complex perineal tear or spares involvement of anal sphincter

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