en.aazsante.fr

The Largest Portal Of Health And Quality Of Life.

Episiotomy: Understand when perineal cut is even needed in normal delivery

Episiotomy: Understand when perineal cut is even needed in normal delivery

The episiotomy is a surgical cut, about five to six centimeters long, performed in the perineum region, from the vagina, and that wants to enlarge the to facilitate the passage of the baby in the last phase of the expulsive, avoiding a possible irregular laceration. It is done with local anesthesia if the patient has not yet undergone other types of anesthesia.

This is a medical practice that has come and is still being performed without having been properly evaluated under the scientific criteria necessary to

We emphasize that episiotomy is not usually discussed previously as it should with the patient during pregnancy.

It became very popular in the 40s and 50s when the act of the delivery from the home environment to the hospital environment. It was argued that a surgical cut in the skin and musculature of the perineum prevented the ruptures or irregular lacerations of the region caused by the passage of the baby at the time of delivery. Thus, instead of a traumatic wound, a regular cut would be made, the restoration of which would be more precise. In addition, it was said that the expansion of this region accelerated the exit of the baby, thus gaining time in the dynamics of mass hospital deliveries.

The episiotomy was higher than the incidence of 90%, practically part of the a routine routine of routine delivery, slowly reducing its frequency from the 1970s and 1980s.

But is episiotomy an indispensable procedure?

There is a worldwide trend today to make episiotomy a selective and unsystematic maneuver, since there is no scientific evidence to prove greater benefits.

In Brazil, it is currently practiced in more than half of the cases (53.5%). And although the World Health Organization (WHO) recommends doing so in only 10% of births, there is a consensus among researchers that the ideal rate would be 15% and should not exceed 30%.

It is the role of the physician obstetrician during the prenatal period, to orient the pregnant woman well for the practice of massage and simple muscular exercises of the pelvic floor, with which the woman can achieve excellent control in the level of contraction and relaxation of the perineum and with that to obtain the sufficient amplification of the channel

These exercises will help, toning and strengthening the perineum, facilitating recovery and reducing discomfort.

Another recommendation that is very encouraging is to encourage the pregnant woman to perform squatting movements since the 4th month of gestation, as well as walking throughout the labor. In this way, it is possible to physically avoid both spontaneous rupture and episiotomy in the vast majority of cases. Another practice that is particularly indicated and that is supported by comparative clinical studies is to adopt vertical or squatting, whose evolution is faster, more comfortable and that facilitates the widening of the birth canal, requiring no further intervention.

Let us emphasize that episiotomy is not usually discussed previously as it should, with the patient during gestation. That is, the act is carried out without the proper informed and informed consent, increasingly demanded by the regulatory medical institutions, faced with the possibilities of a series of complications that the act may entail. My opinion is that the obstetrician should always provide the patient with anticipatory information about situations and needs that may arise during the gestation, parturition and puerperium process, except in special emergency situations, where the benefits outweigh the risks. >In addition to the cesarean section, episiotomy is the most used procedure in obstetrics in Brazil. Its routine use, according to the Brazilian Federation of Gynecology and Obstetrics Societies (FEBRASGO), can lead to a series of negative consequences such as: cicatricial changes, infection, hematoma, traumatic extension of the episiotomy with an injury, for example, of the rectum or nerves of the region In addition to being able to cause dyspareunia (pain in intercourse)

Care after episiotomy

In normal postpartum recovery, care should be taken in the perineal region, with special attention:

In the first few hours, cold compresses that relieve pain and reduce the inflammatory reaction

  • It is advisable to avoid physical exertion, sudden movements and attention to the lumbar posture
  • Stop with the use of tight or synthetic clothes that can increase the discomfort in the region of points
  • Clean the area with only mild soap, in gentle movements
  • other products or excesses may irritate the tissues
  • From the second day, if necessary, use of local heat (seat bath) helps to reduce pain
  • Dry the intimately well in delicate movements, avoiding greater trauma
  • In case of greater discomfort, use analgesics (local and systemic) and anti-inflammatory, always under medical advice
  • Please inform your doctor if you have constipation or burning when you urinate.
  • Please remember that these stitches do not need to be removed, since the external ones fall naturally in the first week and the most internal (if used) are absorbed by the body within an average term of six weeks postpartum


Alcohol use may be linked to frequent access to social networks

Alcohol use may be linked to frequent access to social networks

According to research by Weill Cornell Medical College in the United States, which will be published in the journal Addictive Behaviors , young people who ingest alcohol spend more time on the computer for recreational use - which includes browsing social networks and downloading and listening to music.

(Family)

Stressed parents favor childhood obesity

Stressed parents favor childhood obesity

Parents who experience a very stressful routine can adopt bad habits and encourage excessive weight gain in their children. This is what an American study published on the 22nd day of the online version of the journal Pediatrics points out. The results can help improve prevention and combat childhood obesity.

(Family)