Surgical incision of the perineum and the posterior vaginal wall
Episiotomy
Medio-lateral episiotomy as baby crowns
Pronunciation
/əˌpiːziˈɒtəmi,ˌɛpəsaɪˈ-/
Other names
Perineotomy
Specialty
obstetrics
ICD-9-CM
73.6
MeSH
D004841
MedlinePlus
002920
[edit on Wikidata]
Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing the baby to pass through. The incision, which can be done from the posterior midline of the vulva straight toward the anus or at an angle to the right or left (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured after delivery.
Its routine use is no longer recommended, as perineal massage, a form of the plastic surgeon's principle of 'skin tissue expansion' applied to the vaginal cavity, is an alternative painless method of enlarging the orifice for the baby.[1][2][3] It is nonetheless one of the most common surgical procedures specific to women. In the United States, as of 2012, it was performed in 12% of vaginal births.[1] It is still widely practiced in many parts of the world, including Korea, Japan, Taiwan, China, and Spain.[4][5]
^ abAmerican College of Obstetricians Gynecologists' Committee on Practice Bulletins—Obstetrics (July 2016). "Practice Bulletin No. 165: Prevention and Management of Obstetric Lacerations at Vaginal Delivery". Obstetrics and Gynecology. 128 (1): e1–e15. doi:10.1097/AOG.0000000000001523. PMID 27333357. S2CID 20952144.
^Eason E, Labrecque M, Wells G, Feldman P (March 2000). "Preventing perineal trauma during childbirth: a systematic review". Obstetrics and Gynecology. 95 (3): 464–471. doi:10.1016/s0029-7844(99)00560-8. PMID 10711565.
^Beckmann, Michael M.; Stock, Owen M. (30 April 2013). "Antenatal perineal massage for reducing perineal trauma". The Cochrane Database of Systematic Reviews (4): CD005123. doi:10.1002/14651858.CD005123.pub3. ISSN 1469-493X. PMID 23633325.
^Chang SR, Chen KH, Lin HH, Chao YM, Lai YH (April 2011). "Comparison of the effects of episiotomy and no episiotomy on pain, urinary incontinence, and sexual function 3 months postpartum: a prospective follow-up study". International Journal of Nursing Studies. 48 (4): 409–418. doi:10.1016/j.ijnurstu.2010.07.017. PMID 20800840.
^Graham ID, Carroli G, Davies C, Medves JM (September 2005). "Episiotomy rates around the world: an update". Birth. 32 (3): 219–223. doi:10.1111/j.0730-7659.2005.00373.x. PMID 16128977.
Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is...
from botched episiotomies and poor stitching, that lead women to have pain during sexual intercourse and while urinating. Episiotomies have become a...
mother. The intention is also to attempt to: eliminate the need for an episiotomy during an instrument (forceps and vacuum extraction) delivery; to prevent...
perineal tear is distinct from an episiotomy, in which the perineum is intentionally incised to facilitate delivery. Episiotomy, a very rapid birth, or large...
delivery if the mother had an episiotomy or tearing at the opening of the vagina, it is stitched. In the past, an episiotomy was routine. However, more recent...
is no longer recommended, and not having an episiotomy is found to have better results than an episiotomy, it is one of the most common medical procedures...
haphazard manner, obstetricians and, less frequently, midwives may perform an episiotomy, which is a deliberate cut made in the perineum starting from the fourchette...
difficult to repair. A 2017 Cochrane review compared episiotomy as needed (restrictive) with routine episiotomy to determine the possible benefits and harms for...
associated with significant lacerations or interventions are used such as episiotomy or operative (forceps/vacuum extraction) deliveries or in situations where...
inclusion cyst. It develops within vaginal tissue present at the site of an episiotomy or other vaginal surgical sites. In most instances they do not cause symptoms...
include a history of sexual assault, endometriosis, vaginitis, or a prior episiotomy. Diagnosis is based on the symptoms and examination. It requires there...
was associated with a reduction in the use of epidurals, with fewer episiotomies or instrumental births, and a decreased risk of losing the baby before...
Vaginal stenosis is often caused by radiation therapy to the pelvis, an episiotomy, or other forms of surgical procedures. Chemotherapy can also increase...
of the uterus, rectum, or even the urinary bladder. Perineal tears and episiotomy often occur in childbirth with first-time deliveries, but the risk of...
especially if the bleeding won't stop. Vaginal trauma also occurs during an episiotomy and vaginal childbirth. Avoiding vaginal injuries during childbirth will...
the use of anesthetic medications and surgical interventions such as episiotomies, forceps and ventouse deliveries and caesarean sections. Natural childbirth...
caused by physical injury, nerve injury, prior surgeries (such as an episiotomy), constipation, diarrhea, loss of storage capacity in the rectum, intense...
in the vaginal opening, and other structures within the perineum. An episiotomy (a pre-emptive surgical cutting of the perineum) is sometimes performed...
Rotation of the shoulder (Rubin maneuver); Manual delivery of posterior arm; Episiotomy; Roll over on all fours. Typically the procedures are performed in the...
theorize that this may decrease the risk of tearing and reduce the use of episiotomy. A 2014 review reported that water immersion during the first stage of...
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