What are the sequelae of hysterectomy?

When the fetal head is too large during labor or the mother herself is too old to give birth, the doctor will choose to perform an episiotomy on the mother in order to use external force to assist in delivery. However, because episiotomy is not a normal part of the delivery process, it will leave some sequelae. Postpartum incontinence, unbearable pain during sexual intercourse, and rupture during the second delivery are common sequelae of episiotomy.

Effects on postpartum urinary incontinence in women

Experts point out that regardless of whether the perineum is incised during delivery, the baby will still pass through the birth canal. As for whether it will affect the problem of postpartum urinary incontinence, it is actually related to factors such as the size of the mother's pelvis, the size of the baby, and the speed of delivery. If the delivery process is long, the baby stays in the birth canal for a long time, and the vagina is stretched for a long time, it is more likely to cause postpartum urinary incontinence. This has no absolute relationship with whether the episiotomy is performed or not.

Effect on future dyspareunia

The tear during childbirth will affect the pain during sexual intercourse because the scar after suture is a harder fibrous tissue compared to the soft vulva. During sexual intercourse, the traction between them can easily cause pain. If the wound from the episiotomy or tear is smooth and there are no poorly healed scars after repair, there will be no problem. On the contrary, if the wound is messy and the doctor does not repair it properly, the scars will be intertwined and entangled with each other, and sexual intercourse pain is very likely to occur.

The impact of wounds on the birth of a second child

The blood circulation in the perineum is very good and the blood flow is sufficient, so the wound healing ability is very good and will not affect the delivery of the second child.

The following situations require episiotomy:

1. If the perineum has poor elasticity, a narrow vaginal opening, or there is inflammation or edema in the perineum, it is estimated that severe perineal tearing is inevitable when the fetus is delivered.

2. The fetus is large, the fetal head is in an incorrect position, and the labor force is weak, so the fetal head is blocked by the perineum.

3. For older mothers over 35 years old or those with high-risk pregnancies such as heart disease, pregnancy-induced hypertension syndrome, etc., in order to reduce the physical exertion of the mother, shorten the labor process, and reduce the threat of delivery to the mother and baby, an episiotomy should be performed when the fetal head descends to the perineum.

4. The cervix is ​​fully dilated and the fetal head is low, but the fetus has obvious hypoxia, the fetal heart rate changes abnormally, or the heartbeat rhythm is uneven, and the amniotic fluid is turbid or mixed with meconium.

5. When using forceps to assist delivery.