Episotomy and care

The episiotomy is the cut that is made in the perineum1 of the woman to avoid tears of the same that can lead to complications that could be important such as fistulas, so frequent in African countries where the majority of deliveries are not attended by health personnel. This episiotomy should not be done routinely but only when necessary. It is performed at the moment when the fetal head is crowning the mother's perineum to section the minimum necessary tissues. The episiotomy never increases the dilation of the cervix since it is performed in the perineum of the woman at the time when the fetus is crowning, that is, once there has been a complete dilation of the neck and the descent of the fetal head is almost complete. completed.

The episiotomy can be:

• Mediolateral: from the vulvar fork2 in an oblique direction (about 45º) to the right or left according to the surgeon's preferences. It is the most frequent.

• Middle or central: from the vulvar fork in a vertical direction towards the anus without reaching it.

• Lateral: from the lower third of the labia minora, currently almost unused.

After the delivery period, it is sutured in planes so that some points will remain inside and others will be visible from the skin.

Proper hygiene of postpartum episiotomy is very important. It should be cleaned with soap and water several times a day and each time after urinating and defecating, the area should always be kept dry, so the use of a hair dryer is recommended. The compresses should be changed frequently and used cotton. Sometimes it is advisable to use ice packs to prevent or improve the swelling that may appear. The stitches usually dissolve on their own but in some cases the doctor or midwife may proceed to remove them.

A diet rich in fiber and with plenty of fluids is recommended to avoid constipation.