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Episiotomy & Episiorrhaphy: Dr. Sumayya
Episiotomy & Episiorrhaphy: Dr. Sumayya
DR. SUMAYYA
CONTENTS
• DEFINITION
• PURPOSE
• INDICATIONS
• ADVANTAGES
• TYPES
• PREPARATION AND TECHNIQUE
• EPISIORRHAPHY(REPAIR)
• PERINEAL CARE
• COMPLICATIONS
DEFINITION
• A deliberate surgical incision made on the
perineum to widen or increase the diameter
of the vulva outlet to facilitate vaginal
delivery,it is given during the second stage of
labour,at crowning(when the head is visible at
the introitus and does not recede in between
contractions).
PURPOSE
• To enlarge the vaginal introitus
• To facilitate easy and safe delivery
• To minimize rupture of the perineal muscles
and fascia(prevent perineal laceration)
• To prevent prolonged and overstretch of the
perineum which predisposes to prolapse and
stress incontinence
• To reduce stress on fetal head
INDICATIONS
• MATERNAL
• Anticipating perineal tear(in primigravidae)
• Old perineal tear about to rupture
• Prolonged second stage due to rigid perineum
• forceps/vacum
• Vulval edema
• FETAL
• Fetal distress(presenting part already on the
perineum)
• Big baby
• Face to pubis delivery
• Breech delivery
• Shoulder dystocia
• Preterm baby
CONTRAINDICATIONS
• Bleeding diathesis
• HIV infection
• Rhesus negative women with rhesus positive
fetus
• Face presentation
ADVANTAGES
MATERNAL FETAL