episotomy.pptx,........... .............

Episotomy

1. episotomy Presentation of midwifery and obstretics nursing

2. Defination - It is also known as perineotomy . It is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labour .

3. Time of episiotomy-

4. Indication of episotomy - Prolonged second stage of labor. Fetal distress. Forcep and vacum delivery. Baby in breech pesentation . Twins or multiples deliveries. Large size of baby. Abnormal position of the baby head The mother has a history of pelvic surgery. Hydrocephalus Cord prolapse Face presentation

5. Types of episiotomy- Medio -lateral Medline Lateral episiotomy J-shaped

6. Degree of episiotomy- First stage Second stage Third stage Fourth stage

7. Preparation of articles

8. Steps of episiotomy- Step 1- 10 ml lignocane [1% ]local anesthesia Clean the perineum area [antiseptic solution]. Step2- Incision. To prevent injury of presenting part. Step 3- Placenta delivery then reparing .

9. Layers- The repair is to be done in the following orders; Vaginal mucosa Perineal muscles Skin

10. Scale of episiotomy REEDA scale- R-Redness E –edema E –ecchymosis D –discharge A - allignment

11. Care of episiotomy- Local wound care Pain mangment During the first 12 hour after delivery, an ice pack may be helpful in preventing both pain and swelling of the site of the episiotomy The episiotomy site should be cleaned after a bowel movement or after urination Kegel exercise- help make the muscles strong Removal of stitches- non absorable [6 th day]

12. Risk of episiotomy- Bleeding Infection Painful sex Injury to the anal sphincher and rectum Scarring Urinary incontinence Prolonged recovery time