Indications of episiotomy SlideShare

Episiotomy. 1. EPISIOTOMY A surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labor. 2. OBJECTIVES • To enlarge the vaginal introitus - Facilitate easy and safe delivery of the fetus ( spontaneous or manipulative. ) • To minimize overstretching and rupture of the perineal muscles and. 6. • the mediolateral episiotomy be performed as a two-step procedure. The first incision is made in the soft tissues of the fourchette and the vagina, followed by incision of the perineum, extending in the mediolateral direction.•. Repair is similar to the midline repair. Blood loss can be greater, however, and for this reason repair often. Episiotomy. 1. EPISIOTOMY Fahad zakwan. 2. Definition: It is an intrapartum incision of the perineum to widen the introitus. 3. Benefits: •Prevention of perineal lacerations by anatomical incision and repair of the episiotomy. •Prevention of prolonged and overstretch of the perineum which predisposes to prolapse and stress incontinence

You just clipped your first slide! Clipping is a handy way to collect important slides you want to go back to later. Now customize the name of a clipboard to store your clips 1. Episiotomy and itsrepair Lt Kalaivani R 2. Episiotomy Definition Purpose Indications Advantages Types Perineal repair Perineal Care Complication 3. Definition A surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour is called episiotomy. 4 EPISIOTOMY (PERINEOTOMY) Dr Ali Abd El Monsif Thabet Episiotomy is the most common operation in obstetrics. It is an incision in the perineum that either the midline - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 5a9474-MjUw Episiotomy. Prepared by: Dr. Kasturi Malla Senior Consultant Gynecologist & Obstetrician: Government of Nepal Visiting Professor: CTGU February,2009 Defn.:- Incision over the perineum and posterior vaginal wall in 2nd stage of labor in order to ease the delivery of fetus by enlarging vaginal introitus and prevent the tear of perineal muscle and fascia.. 2 Indication Episiotomy is a surgical incision made in the perineum between the vaginal orifice and the anus during vaginal delivery to allow the baby to be smoothly delivered

Performing an Episiotomy this is an excerpt from the full perineal repair video available on this channel An educational Video about repair of perineal traum.. Infection is possible. For some women, an episiotomy causes pain during sex in the months after delivery. A midline episiotomy puts you at risk of fourth-degree vaginal tearing, which extends through the anal sphincter and into the mucous membrane that lines the rectum. Fecal incontinence is a possible complication Chart and Diagram Slides for PowerPoint - Beautifully designed chart and diagram s for PowerPoint with visually stunning graphics and animation effects. Our new CrystalGraphics Chart and Diagram Slides for PowerPoint is a collection of over 1000 impressively designed data-driven chart and editable diagram s guaranteed to impress any audience

An episiotomy is an incision (cut) made in the area between a woman's vagina (birth canal) and rectum. Pregnant women have this procedure done during the second stage of labor to make the vaginal opening larger. During the second stage of labor, the uterus (womb) contracts (squeezes) to push your baby out. The second stage of labor ends when. Learn how to do and repair episiotomies: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/normal-labor-and-delivery/management-of-normal-de..

Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician.Episiotomy is usually performed during second stage of labor to quickly enlarge the opening for 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. An episiotomy used to be a normal part of childbirth, but it has become much less common in recent years. In the past, an episiotomy was done to help prevent severe vaginal tears during delivery

If you had an episiotomy or a vaginal tear during delivery, the wound might hurt for a few weeks. Extensive tears might take longer to heal. While you're healing, expect the discomfort to progressively improve. Contact your health care provider if the pain gets worse, you develop a fever or you notice signs of an infection indications for each method. 2. Describe the mnemonic for the safe use of vacuum and forceps for operative vaginal delivery. 3. Describe the appropriate documentation that should be recorded after every operative vaginal delivery. Introduction Operative vaginal delivery refers to the use of a vacuum or forceps in vaginal deliveries Episiotomy Definition Purpose Indications Advantages Types Perineal repair Perineal Care Complication 3. Definition A surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour is called episiotomy. 4 Pertinent Points: - Continuous stitching for the repair of an episiotomy or a second-degree. 2 WOUND HEALING & MANAGEMENT THE WOUND Injury to any of the tissues of the body, especially that caused by physical means and with interruption of continuity is defined as a wound.1Though most often the result of a physical cause,

Presentation episiotomy - SlideShar

Sitz bath or hip bath is a bath in which a patient sits in water up to the hips to relieve discomfort and pain in the lower part of the body. Sitz bath works by keeping the affected area clean and increasing the flow of blood.. Definition. Sitz bath or hip bath is a bath in which a patient sits in water up to the hips to relieve discomfort and pain in the lower part of the body Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain. Back pain, belly pain, or blood in the urine. May be signs of a kidney stone. Seizures . A very bad and sometimes deadly type of anemia called hemolytic anemia has happened with ceftriaxone Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration. Appropriate management of postpartum hemorrhage requires prompt diagnosis and treatment. The Four T's. Symptoms. Most hernias cause a bulge under the skin (except hiatus hernias). The location of this bulge depends on the specific type of hernia. For example, an inguinal hernia appears as a bulge in the groin, while an umbilical hernia appears as a bulge near the navel. Some hernias can cause twinges of pain or a pulling sensation, but most do.

PPT - EPISIOTOMY (PERINEOTOMY) PowerPoint presentation

Lecture-10 Episiotomy - Scrib

  1. es blood from the fetal umbilical cord to detect fetal abnormalities. Fetal and maternal blood supply are typically connected in utero with one vein and two arteries to the fetus. The umbilical vein is responsible for delivering.
  2. During the Philadelphia Episiotomy Intervention Study, researchers inserted an Episiotomy Indication Template in the delivery database at community hospitals. The template asks clinicians to document the reason for each episiotomy they did. In the end, this approach resulted in a significant reduction in episiotomy rates over 1 year
  3. istered are then considered to be fluid overloads, and should be removed to prevent iatrogenic heart failure. Dialysis can be used to remove excess fluids from patients' bodies
  4. Indications for operative vaginal delivery24 Type Indication Fetal Presumed fetal compromise (see text) Maternal To shorten and reduce the effects of the second stage of labour on medical conditions (e.g. cardiac disease Class III or IV*, hypertensive crises, myasthenia gravis, spinal cord injury patients at risk of autonomic dysreflexia
  5. Episiotomy increases the risk of blood loss and anal sphincter tears; this procedure should be avoided unless urgent delivery is necessary and the perineum is thought to be a limiting factor.26
  6. Episiotomy is used in many deliveries for first-time mothers despite the fact that there is little evidence to support the frequent use of this technique (Sleep et al., 1989). In fact, episiotomies have been shown in some cases to cause an increase in the rate of perineal trauma (Moller Bek and Laurberg, 1992)

Am Fam Physician. 2011 Sep 15;84 (6):653-660. Prompt diagnosis and treatment of infectious arthritis can help prevent significant morbidity and mortality. The acute onset of monoarticular joint. Assisted Vaginal Birth (Green-top Guideline No. 26) This guideline provides evidence-based information on the use of forceps and vacuum extractor for both rotational and non-rotational operative vaginal deliveries. Access the PDF version of this guideline. This update was undertaken as part of the regular updates to Green-top Guidelines as. A bimanual vaginal examination may need to be performed in a number of different clinical scenarios including unexplained pelvic pain, irregular vaginal bleeding, abnormal vaginal discharge and as part of the assessment of a pelvic mass. Bimanual vaginal examination frequently appears in OSCEs and you'll be required to demonstrate excellent communication and practical skills Primary post-partum haemorrhage is the loss of >500 ml of blood per-vagina within 24 hours of delivery. It can be classified into two main types: Minor PPH - 500-1000ml of blood loss. Major PPH - >1000ml of blood loss. It is a major cause of obstetric morbidity and mortality worldwide. In this article, we shall examine the risk factors.

5.7.1 Indications. • Head engaged and arrested for more than an hour, and vacuum extraction alone has already failed or is likely to do so. • Foeto-maternal disproportion due to a pelvis that is slightly too narrow: after the trial of labour has failed, and at least 3/5 of the head has descended into the pelvic cavity Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion Compartment Syndrome Symptoms. Acute compartment syndrome usually develops over a few hours after a serious injury to an arm or leg. Some symptoms of acute compartment syndrome include

Episiotomy - Types, Risks & Complication

Episiotomy is usually given under local anesthesia ( 1% Xylocain) at the time of crowning of head. The sharp blade of the instrument is The common indications for LSCS are fetal distress in first stage, CPD , abnormal presentations like transverse lie , brow , breech in primi ,previous two scars on the uterus Shoulder dystocia was first described in 1730 and is an uncommon obstetric complication of cephalic vaginal deliveries during which the fetal shoulders do not deliver after the head has emerged from the mother's introitus. It occurs when one or both shoulders becomes impacted against the bones of the maternal pelvis, as shown in the image below

Operative obstetrics by Dr muhammad bilal

How to Perform an Episiotomy - YouTub

  1. Episiotomy is one of the most common surgical procedures in Western medicine. Thacker and Banta 46 published an extensive literature review describing the benefits and risks of episiotomy as known up to 1983. The authors reported that there was no clearly defined evidence supporting the efficacy of episiotomies, especially with respect to.
  2. In this session we review the key information to be communicated to women who have just given birth and their partners and/or families. This covers general care of both the mother and the baby as well as danger signs in the postnatal period. Special mention is made for supporting women with depression.This topic is used to practise the skills of facilitating family and group support and.
  3. The lithotomy position is often used during childbirth and surgery in the pelvic area. It involves lying on your back with your legs flexed 90 degrees at your hips. Your knees will be bent at 70.
  4. ute. It can vary by 5 to 25 beats per
  5. If you've delivered a baby by C-section and you're pregnant again, you might be able to choose between scheduling a repeat C-section or a vaginal birth after cesarean (VBAC). For many women, attempting a trial of labor after cesarean (TOLAC) is possible. In 2013, the success rate for women in the U.S. who attempted a trial of labor after one.
  6. Review for indications. Prostaglandin E2 (PGE2) is available in several forms (3 mg pessary or 2-3 mg gel). The prostaglandin is placed high in the posterior fornix of the vagina and may be repeated after 6 hours if required. Monitor uterine contractions and fetal heart rate of all women undergoing induction of labour with prostaglandins
  7. Routine use of episiotomy. Routine aspiration of. newborn mouth and nose. at birth. Restrict food and fluids in. labor. Other. Kenya. Ethiopia. Tanzania. Zanzibar. Rwanda. Madagascar. Un-indicated Practices 26 17% 8% 7% 3% 3% * No other answer in Kenya. Values from Ethiopia may underestimate due to problem with the question

Explore the Handbook. Introduction. Welcome to FPHandbook.org! From the World Health Organization; From the United States Agency for International Developmen Bromelain is a group of enzymes found in pineapple juice and in the pineapple stem. People sometimes use it as a medicine. Bromelain is used for pain, muscle soreness, burns, and many other. Labor and Delivery (antepartum, intrapartum and postpartum care) By the end of the OB/GYN Clerkship Labor and Delivery component, the BUSM III student will be able to. List the signs and symptoms of normal labor. Describe the three stages of normal labor. Recognize common abnormalities of labor 59. Mohammadi A, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Javadzadeh Y, Fardiazar Z, Effati-Daryani F. Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial. J Integr Med. 2014;12(4):359-266.2507488 Episiotomy in the proper time. Treatment. Any perineal tear should be repaired within 24 hours. Incomplete perineal tear: Can be repaired under local infiltration anaesthesia. First degree tear: The vaginal wall is repaired with continuous locked or interrupted sutures and the skin with interrupted sutures

•Key indicators for Sepsis in NON-PREGNANT adults in the Fairview system includes 2 or more of the following -SBP < 90 -Temperature < 95 or > 101 -HR > 100 beats/min -RR > 20 breaths/min -WBC < 4 or > 12 •Since these indicators may be abnormal in the PREGNANT PATIENT WITHOUT SEPSIS, differen General anesthesia usually uses a combination of intravenous drugs and inhaled gasses (anesthetics). General anesthesia is more than just being asleep, though it will likely feel that way to you. But the anesthetized brain doesn't respond to pain signals or reflexes. An anesthesiologist is a specially trained doctor who specializes in anesthesia Lochia in the Postpartum Period. The lochia is the physiological postpartum uterine discharge consisting mainly of blood and necrotic tissue that occur during the first 4-6 weeks after delivery of the baby . (1) Discharge and blood from the area on the uterine wall to which the placenta was attached during the pregnancy Ibuprofen Immediate Release Tablets Description. Ibuprofen. tablets contain the active ingredient ibuprofen, which is (±) -2 - (p - isobutylphenyl) propionic acid.Ibuprofen is a white powder with a melting point of 74-77° C and is very slightly soluble in water (<1 mg/mL) and readily soluble in organic solvents such as ethanol and acetone

Staff Nurse is the first level professional Nurse in the hospital set up. She will be skilled nurse, giving expert bed side care to patient and executing special technical duties in the special areas like OT, ICU etc Changes in Pharmacokinetics and Pharmacodynamics During Pregnancy . CARLA JANZEN, MD, PhD . 2013 . Department of Obstetrics and Gynecology . Division of Maternal-Fetal Medicin infants due to chorioamnionitis, episiotomy infections, postpartum bacteremia, post-caesarean endomyometritis, and post-abortion infection. There is also associated morbidity for the fetus. Additional research has found a causal association with the prevalence and acquisition of HIV in some female populations. Morphologic Criteri Pudendal Block. The pudendal block gets its name because a local anesthetic, such as lidocaine or chloroprocaine, is injected into the pudendal canal where the pudendal nerve is located. This allows quick pain relief to the perineum, vulva, and vagina. A pudendal block is usually given in the second stage of labor just before delivery of the baby COMMON SURGICAL INSTRUMENTS The operating room contains a multitude of instruments fit for accomplishing a number of procedures. Note that this is not an exhaustive list of instruments, but rather some that you will encounter frequently

Episiotomy: When it's needed, when it's not - Mayo Clini

A vaginal hematoma is an injury that's similar to a deep bruise in your vagina. Any type of injury or trauma to this area, including childbirth, can cause a vaginal hematoma. We'll go over the. VE has a long history. The initial applications of vacuum techniques in deliveries began in the 18th century. While VE became widely popular in Europe, the technique was little used in the United States until after the early 1980s, following the introduction of a series of new instruments, including disposable soft-cup extractors, new rigid cup designs, and handheld vacuum pumps A woman's vagina and the surrounding tissues are likely to tear during the delivery process. Sometimes these tears heal on their own. If a tear is more serious or the woman has had an episiotomy (a surgical cut between the vagina and anus), her provider will help repair the tear using stitches. 4,5; Problems with the umbilical cord - Absence of fluid draining after rupture of the membranes is an indication of reduced volume of amniotic fluid, which may be associated with fetal distress. Provide encouragement and supportive care. Review progress of labour using a partograph. Note: Observe the woman closely. Malpresentations increase the risk for uterine rupture because of. Examining data from 1 961 829 pregnancies and 7308 events, they reported an increase in the risk of all stillbirths and unexplained stillbirths (OR 1.47, 95% CI 1.20-1.80). These findings have been disputed: 33 the indication for the caesarean may account for the increase

Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping ().It is a gynecologic procedure used for diagnostic and therapeutic purposes, and is the most commonly used method for first trimester miscarriage or abortion Postpartum infections comprise a wide range of entities that can occur after vaginal and cesarean delivery or during breastfeeding. In addition to trauma sustained during the birth process or cesarean procedure, physiologic changes during pregnancy contribute to the development of postpartum infections Recently, there have been promising results from a cluster, randomized controlled trial of behavioural interventions to implement clinical guidelines regarding active management of the third stage of labour and selective use of episiotomy in Argentina and Uruguay. 20 The trial compared the effectiveness of a single in-service training (the. Episiotomy, Perineal Injury, and Perineal Repair . 281. KEY ABBREVIATIONS American College of Obstetricians . and Gynecologists ACOG Cephalopelvic Disproportion CPD Left Occiput Anterior LOA Occiput Anterior OA Occiput Posterior OP Occiput Transverse OT Prostaglandins PGs Randomized Controlled Trial RCT Right Occiput Anterior RO

PPT - INJURIES TO BIRTH CANAL PowerPoint presentation

An episiotomy procedure is done so that the opening of the vagina can be made larger to facilitate the birth of a baby. An incision is made in the perineum, the portion between anus and the. 5. An episiotomy incision may bleed heavily at first but usually stops once the doctor closes the wound with sutures. The episiotomy wound normally takes 4 to 6 weeks to heal. The time to heal depends on the length of the incision and the suture material used. Advertisements Episiotomy/Perineum The acronym REEDA is often used to assess an episiotomy or laceration of the perineum. REEDA stands for: Redness Edema Ecchymosis Discharge Approximation Redness is considered normal with episiotomies and lacerations; however, if there is significant pain present, further assessment is necessary

episiotomy simulator Assessment of skills with checklist . symptoms- normal and abnormal Duration Methods of placental separation, expulsion of placenta and indications, dosage, action, side effects and nurses responsibilities in the administration of drugs used for mothers Pharmaco- therapeutics in Obstetric A moist wound environment has been shown to facilitate wound healing, reduce pain, and decrease wound infection. 19 In wounds that are heavily draining, the nurse should apply the type of dressings that will help absorb excess drainage so that an appropriate level of moisture can be maintained in the wound bed. 5

Episiotomy (Aftercare Instructions) - What You Need to Kno

Inserting the speculum. Warn the patient you are going to insert the speculum and ask if they're still ok for you to do so.. If the patient consents to the continuation of the procedure:. 1.Use your left hand (index finger and thumb) to separate the labia.. 2.Gently insert the speculum sideways (blades closed, angled downwards).. 3.Once inserted, rotate the speculum back 90° so that the. Welcome to Midwifery and Obstetrical Nursing Blog! This blog is a platform for me to share all my lecture notes on Midwifery Nursing. Hope this will be useful to all the nursing students out there Vaginal tearing or episiotomy. This will be repaired with dissolvable stitches. 3rd or 4th degree vaginal tear. There's a higher chance of having a vaginal tear that involves the muscle or wall of the anus or rectum, known as a 3rd- or 4th-degree tear. This kind of tear affects: 3 in every 100 women having a vaginal birt ELDERLY PRIMIGRAVIDA AND PREGNANCY OUTCOME. Awad Shehadeh, MD, JB* ABSTRACT . Objective: To examine the obstetric performance of elderly primigravida aged 35 years or over, compared to primigravida between 20 and 25 years of age. Methods: Over a six-year period (1994-2000), the obstetric performance of 172 primigravida aged 35 years or over, was compared to 190 randomly selected young. 3.12 Perineal Care. Perineal care is often referred to as pericare; it consists of external irrigation of the vulva and perineum following voiding or defecation and is part of the routine A. M. and P. M. care. Patients may be able to perform their own perineal care or may need partial or total assistance from the nurse

How to do and Repair an Episiotomy Merck Manual

5. REEDDA: Episiotomy Healing Evaluation. If the mother had an episiotomy or vaginal tear during delivery, the wound might hurt for a few weeks. Extensive tears might take longer to heal. The patient will have a vaginal discharge (lochia) for a number of weeks after delivery. Expect a bright red, heavy flow of blood for the first few days Epidurals, assisted birth (for example, episiotomy, forceps or vacuum) and c-sections are more likely with this method of labour induction. Synthetic oxytocin doesn't work the same way as natural oxytocin - it doesn't cross the blood-brain barrier. Contractions are usually more intense, with not much of a break in between them 1. Intracranial hemorrhage. Precipitous labor can be traumatic for the baby. Instead of labor lasting hours, your baby has to course through the bony pelvis rapidly. This does not allow time for your baby's head to mold to the pelvis. This complication is not common and is most often associated with prematurity

Bleeding in early pregnancy, abortionEpisiotomy

Episiotomy - Wikipedi

Hot and Cold Application - Nursing procedure. Ice Cap: Ice cap is a dry cold application. The ice cap used for the head, has a wide opening that allows it to be filled easily with ice chips, as does the ice collar, a narrow bag curved to fit the neck. Single use ice bags are frequently used. Hot Water Bag Incontinence has many causes. It is not a normal part of aging, but as you age, you may be more at risk for the condition. In order to maintain bowel control, the pelvic area must work correctly. If not, incontinence may occur. Injury or illness can cause a loss of normal function and bowel control. Physical limitations or disabilities, and. The episiotomy wound or perineal or vaginal tears may be infected. Note An endocervical swab should be taken for microscopy, culture, and sensitivity tests. 12-25 How should you manage genital tract infection? Prevention Strict asepsis during delivery. Reduction in the number of vaginal examinations during labour to a minimum A sitz bath or hip bath is a bath in which a person sits in water up to the hips. It is used to relieve discomfort and pain in the lower part of the body, for example, due to hemorrhoids (piles), anal fissures, perianal fistulas, rectal surgery, an episiotomy, uterine cramps, inflammatory bowel disease, pilonidal cysts and infections of the bladder, prostate or vagina

Peripartum CardiomyopathyObs and gyn instruments

In obstetrics, Leopold's maneuvers are a common and systematic way to determine the position of a fetus inside the woman's uterus; they are named after the gynecologist Christian Gerhard Leopold.They are also used to estimate term fetal weight. The maneuvers consist of four distinct actions, each helping to determine the position of the fetus Summary. Skin and soft tissue infections (SSTIs) are a group of heterogeneous conditions affecting the epidermis, dermis, subcutaneous tissue, or superficial fascia.Uncomplicated infections are most commonly caused by gram-positive pathogens (Streptococcus, Staphylococcus) that infiltrate the skin after minor injuries (e.g., scratches, insect bites). ). Complicated infections have a higher. American College of Nurse-Midwives 8403 Colesville Road, Suite 1550 Silver Spring, MD 20910-6374 (240) 485-1800 Fax: (240) 485-1818 www.midwife.org info@acnm.org . Midwifery: Evidence-Based Practice . A Summary of Research on . Midwifery Practice in the United State Caesarean section (NICE clinical guideline 132) This guideline has been developed to help ensure consistent quality care for women who have had a caesarean section (CS) in the past and are now pregnant again or have a clinical indication for a CS or are considering a CS when there is no other indication 2.15 Nursing Care during the Fourth Stage of Labor. a. Transfer the patient from the delivery table. Remove the drapes and soiled linen. Remove both legs from the stirrups at the same time and then lower both legs down at the same time to prevent cramping. Assist the patient to move from the table to the bed Episiotomy used to be routinely performed at this time, but current recommendations restrict its use to maternal or fetal indications. Delivery maneuvers are as follows: The head is held in mid position until it is delivered, followed by suctioning of the oropharynx and nares