EPISIOTOMY (PERINEOTOMY)

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EPISIOTOMY (PERINEOTOMY)

• Dr Ali Abd El Monsif Thabet

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• Episiotomy is the most common operation in
  obstetrics.
• It is an incision in the perineum that either the
  midline (a median episiotomy) or begun in midline
  but directed laterally away from the rectum.
• Episiotomies are necessary in most first
  deliveries and even in many multigravidae women.

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• The advantages of episiotomy
• Indications
• Timing of episiotomy

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Types of episiotomy

• 1. Median episiotomy
• 2. Mediolateral episiotomy

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Management

• Acute perineal pain
• Chronic perineal pain

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PUERPERIUM

• Dr Ali Abd El Monsif Thabet

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NORMAL PUERPERIUM

• The puerperium is the period of adjustment after
  pregnancy and delivery when the anatomic and
  physiological changes of pregnancy are reversed
  and the body returns to the normal nonpregnant
  state.
• The post partum period has been divided into
• The immediate puerperium the first 24 hours
  after parturition - when acute post anesthetic or
  post delivery complications may occur.
• The early puerperium which extends until the
  first week post partum
• The remote puerperium which includes the period
  of time required for involution of the genital
  organs. Traditionally the later period has
  extended through the sixth weeks postpartum.

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• Uterine Involution
• Muscles
• The causes of sub involution of the uterus
• After Pains

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Abnormal PUERPERIUM

• Varicose veins
• Breast Engorgement
• Diastasis of recti abdominis muscles (DRAM)
• Coccydynia

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Thank you