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Labour

Question
9 out of 23
 

All the following are TRUE about an episiotomy EXCEPT (AIIMS Nov 2009)



A Increased the size of the birth canal

B Midline episiotomy causes less bleeding, heals early and is easily repaired

C Anal sphincter involvement is in type 3rd degree perineal tear

D Midline and mediolateral are commonly employed

Ans. A

Increased the size of birth canal

a. Episiotomy - A surgically planned incision on the perineum and the posterior vaginal walls during the second stage of labour is called episiotomy (perineotomy) It is infect an inflicted second degree perineal injury.

b. It is the most common obstetric operation performed

c. Timing of the episiotomy - bulging thinned perineum during contraction just prior to crowning is the ideal time

d. Relative merits and demerits of median and medio-lateral episiotomy

Median (midline)

Medio-lateral

1. The muscles are not cut

1. It necessary if the incision can be extended

2. Blood loss is least

2. Blood loss is little more

3. Repair is easy and healing is superior

3. Apposition of the tissue is not so good relative

4. wound disruption is rare

4. increased incidence of wound disruption

5. Post-operative discomfort is minimal

5. Post-operative discomfort is more (maximum)

6. Dyspareunia is rare

6. Dyspareunia is comparatively more

7. Extension, if occurs may involves the

7. Relative safety from rectal involvement

rectum (common)

8. Anatomical results excellent

8. Occasionally faulty

e. Laceration of the birth canal

First degree - involves fourchette, perineal skin, vaginal mucous membrane

Second degree - skin, and mucous membrane, fascia and muscle of the perineal body

Third degree - skin, mucous membrane, perineal body and involves anal sphincter

Fourth degree - extends through then rectal mucosa to expose of the urethra that may bleed profusely

Labour Flashcard List

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