EPISIOTOMY REPAIR-1-1.pptx

Kibondo

1. UTILIZE CLINICAL SKILL IN PERFORMING EPISIOTOMY PRESENTER: Dr. @BENNIEH 11/25/2022 Dr Nyaga 1

2. LEARNING OBJECTIVES Explain episiotomy Describe indications for episiotomy Describe contraindications for episiotomy Explain complications associated with episiotomy Prepare equipment for episiotomy Prepare pts for episiotomy Perform episiotomy 11/25/2022 Dr Nyaga 2

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5. INDICATIONS OF EPISIOTOMY Common indications are; Threatened perineal injury in primigravidae Rigid perineum Forceps , breech , occipitoposterior or face delivery. Other indication are; Big baby Shoulder dystocia Face to pubis delivery 11/25/2022 Dr Nyaga 5

6. Timing of the episiotomy The timing of performing the episiotomy requires judgement. If done early , the blood loss will be more . If done late, it fails to prevent the invisible lacerations of the perineal body and thereby fail to protect the pelvic floor –the very purpose of the episiotomy is thus defeated. Bulging thinned perineum during contraction just prior to crowning [when 3-4 cm of head is visible] is the ideal time. 11/25/2022 Dr Nyaga 6

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8. Types of episiotomy The following are the various types of episiotomy; Mediolateral Median Lateral J shaped 11/25/2022 Dr Nyaga 8

9. Mediolateral incision 11/25/2022 Dr Nyaga 9

10. Cont ….. Mediolateral ; The incision is made downwards and outwards from the midpoint of the fourchette either to the right or to the left. It is directed diagonally in a straight line which runs about 2.5 cm away from the anus [midpoint btn anus and ischialbtuberosity ]. 11/25/2022 Dr Nyaga 10

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15. Lateral episiotomy The incision start from about 1 cm away from the center of the fourchette and extends laterally. It has got many drawbacks including chance of injury to the Bartholin’s duct. 11/25/2022 Dr Nyaga 15

16. J shaped The incision begins in the center of the fourchette and is directed posteriorly along the midline for about 1.5 cm then directed downwards and outwards 5 or 7o’clock position to avoid the anal sphincter. 11/25/2022 Dr Nyaga 16

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