A hole opened in the episiotomy wound

Don't be too afraid if the episiotomy wound has a hole. As long as it is treated as soon as possible, the wound will not show any signs of infection. However, you need to be careful not to scratch the wound with your hands, because there will be a lot of bacteria and viruses on your hands. In addition, mothers should also supplement their bodies with sufficient nutrients, so as to shorten the recovery time and course of the disease.

Episiotomy is a surgery to ensure the smooth delivery of the fetus. Episiotomy is to make an oblique incision in the perineum. Episiotomy can prevent perineal tearing and protect the pelvic floor muscles of the mother. In addition to physiological reasons, the deeper reason for performing episiotomy for natural birth in China is the medical accident reverse prosecution system. If a woman giving birth naturally suffers perineal tear due to failure to perform an episiotomy, the hospital can assume all responsibility for not performing an episiotomy when the woman sues. Therefore, in order to avoid unexpected situations, public hospitals in mainland China have a tacit understanding to implement episiotomy for normal deliveries.

In primipara delivery with head presentation, the perineum is tight, long, the tissue is tough or underdeveloped, there is inflammation, edema, or the perineum fails to fully expand during emergency delivery. It is estimated that a degree II or above laceration will occur when the fetal head is delivered.

Head-pelvic disproportion caused by various reasons.

Multiparous women who have undergone episiotomy and suture, or who have large scars after repair that affect the expansion of the perineum.

Forceps-assisted delivery, vacuum extractor-assisted delivery, or vaginal delivery for first-time breech presentation.

Premature birth, intrauterine growth retardation or fetal distress require relief of fetal head pressure and early delivery.

Pregnant women who suffer from heart disease or high blood pressure and need to shorten the second stage of labor.

(I) Timing of incision

When the doctor sees the fetal head about to appear from the vaginal opening, he or she will immediately judge whether the baby is big and whether it will cause severe perineal tear, and then decide whether to perform an episiotomy. If the doctor judges that the delivery is going smoothly and the tear is not large even if the perineum is not cut, surgery can be avoided.

(II) Operation

The patient took the lithotomy position and used bilateral pudendal nerve block anesthesia. When the uterus contracted, the middle and index fingers of the left hand reached deep into the vagina to prop up the left vaginal wall. The perineum was cut open at a 45° angle to the left from the posterior perineum to the midline with episiotomy scissors. However, if the perineum is highly bulging, the cutting angle should be 60° to 70° to avoid damaging the rectum. The incision is generally 4 to 5 cm. After the incision is made, gauze should be applied to compress and stop the bleeding. If necessary, clamps and ligatures should be used to stop the bleeding.

3. Time

There is no need to spend time cutting slowly. Instead, it can be cut quickly and instantly with medical scissors. The length of the cut is only about 2-5cm, and it really feels like "a moment". When the labor pains are severe, some women may not even realize that the incision has been made.

4. Pain level

Since the incision is made at the peak of labor pain, the episiotomy is basically not felt. In addition, due to the effect of local anesthesia, there is no need to worry about pain during incision.