Many mothers who have given birth know that when giving birth, the doctor has to make an incision in their \”lower body\”, which is called an episiotomy in medicine. So, what are the clinical conditions for pregnant women who require episiotomy?
When a pregnant woman gives birth, the folds of the inner vaginal mucosa are fully unfolded and the middle muscle layer is fully expanded, so that the fetus can leave the uterus, pass through the vagina, and come to the human world.
Although the anatomical and physiological characteristics of the vagina are conducive to the smooth delivery of the fetus, in fact, when the fetal head with a diameter of about 10 cm is delivered, if there is no help from a midwife to protect the perineum, the mother\’s perineum will definitely be heavy. Lacerations of varying degrees. Once a laceration occurs, there will be varying degrees of sequelae after delivery.
For example, some women suffer from uterine prolapse due to severe damage to the vagina and perineum, and even tear the anal sphincter and rectum, causing fecal incontinence, which is very painful. If episiotomy can be performed in time, the above-mentioned sequelae will not occur, which is beneficial to both mother and fetus.
Clinically, women with the following conditions require episiotomy.
1. The perineum has poor elasticity, the vaginal opening is narrow, or the perineum is inflamed and edematous. It is estimated that severe tearing of the perineum will inevitably occur when the fetus is delivered.
2. The fetus is large, the fetal head is not in the correct position, the labor force is not strong, and the fetal head is stuck in the perineum.
3. For pregnant women over 35 years old, or high-risk pregnancy combined with heart disease, pregnancy-induced hypertension, etc., in order to reduce the physical exertion of the mother, shorten the labor process, and reduce the risk to the mother and baby during delivery, when the fetal head descends to the perineum, perform perineal surgery incision.
4. The cervix is fully dilated and the fetal head is low, but the fetus is obviously hypoxic, the heart rate changes abnormally, or the heartbeat is irregular, and the amniotic fluid is turbid or mixed with meconium.
5. Forceps delivery.
Everything is split in two. The front part of the perineum is close to the vagina, and the back part is close to the anus, where there are more bacteria. Therefore, an episiotomy is not a sterile procedure. Moreover, there are many bacterial parasites in the vagina.
If the fetal membranes rupture prematurely, the labor process is prolonged, and there is often inflammation and edema in the vagina and perineum, the vaginal incision may heal poorly. Coupled with postpartum defecation and lochia discharge, the incision will also be contaminated and inflamed. Therefore, it is necessary to keep the local area clean and hygienic after episiotomy, and wash it with clean water immediately after each defecation to avoid contamination and injury.