Definition of "Episiotomy"

Last modified: 11 hours



Episiotomy (from Greek "epision" meaning "pubic region", "tomy" meaning "cutting", aka perineotomy) is surgical incision of the perineum and posterior vaginal wall, during the second stage of labor, to quickly enlarge the opening for th ebaby to pass through.

Patient information

What is episiotomy? I know that -otomy means a cut, so do you cut the episi? What's that?
It's where you make a cut in to the perineum. The word "epision" is Greek for the pubic region, so that's why it's called that. But you can also call it a perineotomy .

What's the perineum?
The perineum is the area between the anus and the vulva. Or in men, the scrotum.

Method
  • Performed under local anesthetic, to the pudendal nerve (i.e. main nerve of the perineum)
  • Incision can be done at:
    • 90 degree angle from the vulva towards the anus
    • At an angle from the posterior end of the vulva (medio-lateral episiotomy)
  • Sutured closed after delivery

Patient information

How do you cut the area between the anus and vulva?
You inject local anesthetic into the main nerve of that area, the pudendal nerve. You can then do the incision at whatever angle you like. And then you suture it back up, after bub has been delivered.

Tx
  • Prevention, by birth canal widening (aka antenatal perineal massage), performed before the start of labour and achieving a 10cm opening to the birth canal so the baby's head can pass through easily. The procedure is safe and painless

Patient information

What can you do to avoid cutting the area between the anus and vulva?
Massage the perineum, to help it stretch more easily.

Complications
  • PPH (>500mL blood loss during childbirth, or >1L with a C section)

Patient information

What bad things can happen as a result of cutting the area between the anus and vulva?
Bleeding, lots. Which we call PPH when it happens after giving birth.

Epidemiology
  • One of the most common medical procedures performed on women, although its routine use in childbirth has steadily declined
See also

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Definition of Episiotomy | Autoprac


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