Episiotomy

Episiotomy
Medio-lateral episiotomy as baby crowns
Pronunciation/əˌpziˈɒtəmi, ˌɛpəsˈ-/
Other namesPerineotomy
Specialtyobstetrics
ICD-9-CM73.6
MeSHD004841
MedlinePlus002920

Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing the baby to pass through. The incision, which can be done from the posterior midline of the vulva straight toward the anus or at an angle to the right or left (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured after delivery.

Its routine use is no longer recommended, as perineal massage applied to the vaginal opening, is an alternative to enlarge the orifice for the baby.[1][2][3] It was once one of the most common surgical procedures specific to women. In the United States, as of 2012, it was performed in 12% of vaginal births.[1] It is also widely practiced in many parts of the world, including Korea, Japan, Taiwan, China, and Spain in the early 2000s.[4][5]

  1. ^ a b American College of Obstetricians Gynecologists' Committee on Practice Bulletins—Obstetrics (July 2016). "Practice Bulletin No. 165: Prevention and Management of Obstetric Lacerations at Vaginal Delivery". Obstetrics and Gynecology. 128 (1): e1–e15. doi:10.1097/AOG.0000000000001523. PMID 27333357. S2CID 20952144.
  2. ^ Eason E, Labrecque M, Wells G, Feldman P (March 2000). "Preventing perineal trauma during childbirth: a systematic review". Obstetrics and Gynecology. 95 (3): 464–471. doi:10.1016/s0029-7844(99)00560-8. PMID 10711565.
  3. ^ Beckmann, Michael M.; Stock, Owen M. (30 April 2013). "Antenatal perineal massage for reducing perineal trauma". The Cochrane Database of Systematic Reviews (4): CD005123. doi:10.1002/14651858.CD005123.pub3. ISSN 1469-493X. PMC 11297413. PMID 23633325.
  4. ^ Chang SR, Chen KH, Lin HH, Chao YM, Lai YH (April 2011). "Comparison of the effects of episiotomy and no episiotomy on pain, urinary incontinence, and sexual function 3 months postpartum: a prospective follow-up study". International Journal of Nursing Studies. 48 (4): 409–418. doi:10.1016/j.ijnurstu.2010.07.017. PMID 20800840.
  5. ^ Graham ID, Carroli G, Davies C, Medves JM (September 2005). "Episiotomy rates around the world: an update". Birth. 32 (3): 219–223. doi:10.1111/j.0730-7659.2005.00373.x. PMID 16128977.