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Episiotomy

  • Manishi Mittal
Chapter

Abstract

Episiotomy is a surgical incision given at the perineum during the second stage of labour, in order to enlarge the vaginal orifice and facilitate delivery of the baby. Large disparity has been reported between rates of episiotomy used throughout the world. Appropriate analgesia should be given before performing episiotomy. When performed, mediolateral episiotomy is given on a stretched perineum starting from the posterior fourchette. The incision is preferably given at an angle of 45–60° to the right of the midline. Basic principles of episiotomy repair are correct reapproximation, proper haemostasis and suturing without tension. The episiotomy is usually stitched in three layers—the mucosa, muscle layer and skin. The area of repair should be regularly cleaned with plain soap at least once or twice a day and after urination or defecation. Pain relief can be given with NSAIDs. Complications of episiotomy include haemorrhage, infection, wound dehiscence, obstetric anal sphincter injuries, necrotizing fasciitis and delayed ones like dyspareunia, scar endometriosis and fistula. Routine use of episiotomy is not recommended because there is no evidence for any beneficial effect of routine use.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Manishi Mittal
    • 1
  1. 1.Mittal Maternity and Superspeciality HospitalYamunanagarIndia

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