Friday , October 19 2018
Episiotomy Management Assisted Episiotomy

Management of Episiotomy

An episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth. Although an episiotomy was once a routine part of childbirth, that’s no longer the case.

Purpose of Episiotomy

To make the vaginal opening larger to make it easier for a woman to give birth.

  • Extensive vaginal tearing appears likely
  • Your baby is in an abnormal position
  • Your baby is large (fetal macrosomia)
  • Your baby needs to be delivered quickly

Scope of Episiotomy

All delivered patient who has undergone episiotomy.

Definition-Episiotomy

A surgical cut made at the opening of the vagina during childbirth, to aid delivery and prevent rupture of tissues.

Applicable Areas

Gyneac & Obstetric Department.

Responsibility

Consultant, Medical Officer, Staff Nurse, Auxillary Nurse Midwife and Head Nurse.

Procedure

Performing Episiotomy

  • Observe the perineum for crowning of head as it occurs during the contraction during labour.
  • Infiltrate the perineum with Xylocaine 2% in between contractions.
  • Guard the head by two fingers and incise the perineum without injuring the fetus.
  • Start the incision strictly in the midline of the fourchette and extend its posterior laterally in the left side upto 11/2 inches during the time of contraction.

Assisting Episiotomy

  • Provide lithotomy position to the patient.
  • Provide adequate lighting for procedure.
  • Hand over the suture material on needle holder or any other material as per Gynecologist.
  • Clean vaginal bleeding with gauze mop
  • Retract the vaginal wall with Sim’s speculum to ensure that the apex of the vaginal wound is clearly seen.
  • Assist the doctor throughout the procedure.
  • Provide reassurance to the patient during the procedure.
  • Clean the perineal area with Betadine solution.
  • Apply sterile pads and tie.
  • Make the patient lie comfortably back in supine position.
  • Clean and dry the patient thoroughly.
  • Change into fresh clothing.
  • Provide snacks / meals as desired by patient.

Documentation

  • Nurse’s Observation Sheet.
  • Billing Data Record.