Thursday, July 16, 2009

Care of Episiotomy Wound

What is Episiotomy?


It is a surgical incision at the vaginal outlet which is performed during a normal vaginal delivery.






What is the purposes of Episiotomy ?


1) To assist in the delivery of the baby's head by extending the diameter of outlet.


2) To prevent extensive perineum tear which may injure the anus.


3) To assist in instrumental delivery, such as Forceps and Vacuum delivery.







Is it necessary to perform Episiotomy to all the normal vaginal deliveries?

No. Episiotomy is not a compulsory procedure in normal vaginal delivery. In fact, some of the pregnant mothers refuse to give permission for the doctor to perform episiotomy.

The decision for episiotomy should be based on case to case basis.

For example,
1) First vaginal delivery usually needs episiotomy due to tight outlet.
2) If the doctor suspect the baby is big.
3) When instrumental delivery ( forceps or Vacuum ) is required.


How to take care of Episiotomy wound after the delivery?

The wound will be stitched immediately after the delivery. The healing process usually takes about 1 week.
Things you should do to assist the recovery:

1) Keep the surrounding area clean.


2) Don't rub the wound with tissue paper after passing motion. Use water to clean yourself after passing motion.

3) Some medication to reduce pain and swelling is helpful.

4) Infrared care is sometimes helpful to reduce the pain.




4) Sitz-bath to assist the healing process.



How to do Sitz Bath at home after discharged from hospital?


You need a toilet bowl to perform Sitz bath.



Use warm water, add in 2 to 3 spoons of salt.

Sit on the warm bowl with your buttock is fully soaked.

Duration of sitz bath is about 15 minutes.

Do it 2 to 3 times perday and everytime after you pass motion.

5 comments:

夏娃 said...

Dear Dr Jason Ong,
I went to one of the Hypnobirthing and Breastfeeding class on weekend and found something very interesting
http://hypnobirthing.com.my/class-outline
From your gynae point of view, whats your opinion about Hynobirthing?
Pls share
Cheers,
sushipig

Dr. Jason Ong said...

Hi! sushipig,

This hypnobirthing is something new to me. Frankly, I haven't heard of it.

The website only displays very simple explanation of this hypnobirthing.

I will only elaborate after going through its programme and content.

Since you have attended the class, why not you furnish me with more information so that I can offer you my opinion from the medical point of view.

夏娃 said...

Dear Dr,
I attended the introduction of hypnobirthing only- RM5,the full course charges RM560, burn a big hole in my pocket. During the introductory class, speaker actually try to brainwash us that labour is not that pain after all,just our wild imagination and stereotyping topping up the fear of natural birth. My conclusion of the introduction is RELAXATION. Release your fear by comforting yourself or pampering by all sorts tools like breathing exercise( sounds like antenatal class), soft music, dim light if possible when contracting/no nurse attending,adjust for position to the comfort position.
To be frank I'm not so clear bout the concept of Hypnobirthing as well,I am heading to MPH later to catch up this book
http://www.mph.com.my/search/nsearch.cfm?do=detail&pcode=0757302661
Cheers,
sushipig

Anonymous said...

Dear Dr Jason,

I delivered my baby March this year via natural with forceps. My baby weighted 3.7kg at birth.

Until now my Episiotomy wound/scar is still pain every time I move my legs apart or squat down. FYI, my doc tried twice before managed to delivered my baby with forceps. I remember the 1st attempt, I was pulled down the bed. Could this be the reason my wound still hurts or this is normal?

I always wanted to know what is the standard/maximum diameter of the baby that can successfully pass through the birth canal? My baby head circumference was 34cm at birth.

Thank you and have a nice day!


Cheers,
Alyce

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