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Video Parto Vaginal Normal con episiotomía y sutura - Childbirth + episiotomy

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Published on May 8, 2009

En el video podemos observar un parto normal, atendido el día de hoy 08 de Mayo de 2009, a las 10:10 hrs.
La madre es primeriza, de18 años que alumbra luego de 6 horas de haber empezado el trabajo de parto y con necesidad del uso de oxitocina debido a hipotonía del útero. El parto es eutócico, a término, de 40 semanas y fue necesario practicarle una episiotomía. Sexo masculino, peso=3300 grs, talla:51cms, apgar 10 al minuto. ¡¡Todo bien, como siempre gracias a Dios!!
Se entiende por episiotomía a la realización de una incisión quirúrgica en la zona del perineo femenino, que comprende piel, plano muscular y mucosa vaginal, cuya finalidad es la de ampliar el canal "blando" para abreviar el parto y apresurar la salida del feto. Se realiza con tijeras o bisturí y requiere sutura. La episiotomía como técnica preventiva para evitar desgarros está contraindicada por la Organización Mundial de la Salud. Las episiotomías no previenen desgarros en o a través del esfínter anal ni desgarros vaginales. De hecho, los desgarros profundos casi nunca ocurren cuando no se realiza una episiotomía.
En aquellos casos en que la episiotomía se indica necesaria, se prefiere una incisión mediolateral en vez de una incisión en la línea media por poseer esta un mayor riesgo de daño al esfínter anal y el recto.

Natural Final Vaginal Stage Labor Childbirth: In the video we can observe a normal childbirth, attended today May 08, 2009, at 10:00 hours.
The mother is in her first pregnancy, with of 24 years old that birth gives after 6 hours of beginning the work of childbearing and with need of use of oxitocina because of uterus hypotonique. The childbearing is eutocic, to term, 40 weeks and it was necessary to practise an episiotomy. Masculine sex, weight=3300 grs, height:51cms, apgar 10 to the minute. All good, Truly a Miracle of God!!
An episiotomy is a surgical incision through the perineum made to enlarge the vagina and assist childbirth. The incision can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic (pudendal anesthesia) and is sutured closed after delivery. It is one of the most common medical procedures performed on women, and although its routine use in childbirth has steadily declined in recent decades, it is still widely practiced in Latin America and in Poland and India.

The primary rationale behind an episiotomy is related to the nature rather than the size of the tear. An episiotomy creates a primary intention wound which is easier and less painful to suture, causes less scarring and reduces the risk of infection compared to natural wounds. This is because the natural wounds are typically secondary or tertiary intentions which create poorly related wounds (ragged edges) and shearing between perineal layers slowing healing and increasing the infection risk
Many physicians use episiotomies because they believe that it will lessen perineal trauma, minimize postpartum pelvic floor dysfunction by reducing anal sphincter muscle damage, reduce the loss of blood at delivery, and protect against neonatal trauma. In many cases though, episiotomies cause all of these problems.
Slow delivery of the head, in between contractions will result in the least perineal damage.
Episiotomy is indicated if:
the baby's shoulders are stuck (Shoulder Dystocia) a bony association, though the episiotomy does not resolve this problem, it allows the operator more room to perform maneuvers to free shoulder from the pelvis.
There is a serious risk to the mother of second or third degree tearing
In some cases where a caesearean is not indicated but delivery is adversely affected
'Natural' tearing will cause an increased risk of maternal disease being vertically transmitted
Routine episiotomy is NOT indicated in evidence based practice
Large baby
rigid perineal muscles
When instrumental delivery is indicated
When a woman has undergone FGM (female genital mutilation) an anterior and or mediolateral episiotomy may be indicated.
Prolonged late decelerations or fetal bradycardia during active pushing
Enviado por " CONSULTORIO MÉDICO FLORES BUISSON " MÁNCORA- PERÚ...
URL: http://consultoriomedicofloresmancora... ...

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