Incision during childbirth: indications, technology, consequences, medical opinions

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

The process of giving birth to a child is a real miracle, which is accompanied by extraordinary processes in a woman's body. Preparing a woman for pregnancy is quite popular, but preparation for childbirth is no less important. It is more complex and significant, because it is impossible to predict the possible risks and necessary measures that will have to be taken during childbirth. Today we will analyze the incision during childbirth, what is it called, when, under what conditions, why is it done, and whether it is harmful to the child.

Anatomical characteristics of the incision

In science, this procedure is called an episiotomy. It is allowed to make an incision during childbirth only in the second stage of labor. This stage is characterized by the presence of the child in the outlet of the small pelvis. The head of the child is located in this place, even if there are no attempts, it does not go back, but remains in the small pelvis. This period is called the eruption of the head, thenthere is a baby already visible.

At the moment, in 95% of cases, an incision is made along an oblique line, towards the ischial tuberosities. If you look at the head of the child directly, then you need to make cuts obliquely into the lower left corner. The length of the incision is approximately 2 cm.

The remaining cases are characterized by an incision in a straight line to the anus. This method is more complex and is not used unnecessarily in practice. This type of incision is already called a perineotomy. The size and direction of the incision during childbirth depend on the individual characteristics of the woman and the birth process. Note that in view of the fact that the muscles are stretched and the skin is thin, a woman is not given an anesthetic. She feels no pain from the incision.

Benefits of surgical incision

A birth incision made by a doctor using surgical instruments heals faster than a natural tissue tear. This is related to the following:

1. The edges of the wound are even, they are easier to connect and suture.
2. Tears naturally tend to be deep and heal slowly.
3. The incision is made by a specialist, it will not allow deep tissue divergence and will create all conditions for healing in the future.

Indications for the procedure

Despite the fact that a surgical incision during childbirth is a better option than a natural tissue tear, the procedure requires special indications:

1. Creating an immediate threat of tissue rupture when the skin around the perineum becomes very thin,starts to shine.
2. The size of the fetus is large, which is established before childbirth, so the incision during childbirth is not an emergency event, it is planned in advance.
3. Premature birth when there is an increased risk of injury to the baby.
4. Shoulder dystocia, when the baby's head has already come out, and the shoulders cannot fit through due to their large size.
5. If any obstetric surgery is scheduled during childbirth, the procedure should also be performed.
6. The birth incision is vital to shorten the second stage of labor. This is necessary if the blood pressure is high, the baby's heart disease is diagnosed, the second period has been going on for too long.
7. Fetal hypoxia begins and actively develops when the child lacks oxygen.
8. The baby is not positioned correctly, it is in the pelvic area, this is called "breech presentation".
9. Rigidity of the muscles - a phenomenon in which the muscles are so weak that they cannot create a full push for the exit of the child.
10. When a woman is unable to push on her own.

Slit Technology

The first and indispensable condition for an incision during childbirth is time - it can only be done during the second phase of labor at the moment of maximum effort. Before the incision, you need to treat the tissue with an antiseptic. If the tissues are not sufficiently stretched and the procedure may cause pain, an injection of "Lidocaine" is made:

• The cut is being madesurgical scissors. During the period of rest of the woman in labor between attempts, one part of the scissors (blade), called brush, is inserted into the gap between the baby's head and tissues. The direction must be maintained in such a way that the incision will be made.
• The length of the incision should not exceed 3 cm, a very short incision may be ineffective, and a long incision will hurt, leading to a break.
• Suturing at this stage does not occur, after the placenta is released, the doctor examines the patient and the uterus, after which he stitches. Anesthesia is given prior to suturing. After childbirth, the incision is no longer made, it is only sutured. The stitched place is treated with an antiseptic, this completes the procedure.

There are two main methods of suturing the resulting incision. Let's take a look at each one.

Layer suturing

The incision is sutured starting from the mucous wall of the vagina, after they are sewn, they move on. Submersible sutures connect all cut muscle tissues. In this case, synthetic threads are used, which are able to dissolve. Catgut is a thread made from the fibers of the intestines of an animal, which is sometimes used for suturing, in this case it is prohibited. It can cause allergies. The second layer is already cosmetic stitches, they are small and continuous.

Perineorrhaphy according to Jester

The second method of suturing is perineorrhaphy according to Shute. There is no division into fabrics, all layers are connected at once. Figure-of-eight sutures are applied, but synthetic threads are already needed here, which do not dissolve. After the wound has healed, the threads are simply removed. This method is more dangerous: inflammation and infections often occur.

Recovery after surgery

Recovery in this area is very inconvenient, especially considering that a woman has a newborn that requires constant care and protection. The inconvenience lies in the fact that microorganisms are constantly present in the genital tract, which can get into the wound and cause inflammation. Ligation and permanent processing are not possible. If an incision was made during childbirth, you need to abandon the sitting position, otherwise the seams will open. As a general rule, it is forbidden to sit for 2 weeks, but everything is individual, depending on the level of regeneration and the depth of the incision. The term can last up to 4 weeks. It turns out that only lying and standing positions are allowed.

Suture healing

Sutures after childbirth after an incision heal for about 5-7 days, if the area is properly treated and the recommendations given by the doctor are not violated, there are no infections. After the first week after suturing, the doctor removes superficial sutures and checks the condition of the scar. During the healing period, you must adhere to the following rules:

1. Daily treatment of sutures - midwives in the maternity hospital, as a rule, treat them with brilliant green, while assessing the condition of the young mother.
2. After a shower, you need to lie naked for a while so that the woman dries naturally, otherwise you can get an infection. Wipe the seams only with blotting movementspure material.
3. After each trip to the toilet, it is necessary to rinse the place with a weak solution of potassium permanganate.
4. Put on sanitary pads and change them every 2 hours.
5. You can't lift anything heavy, the only exception is a child, you can't touch anything heavier than him.
6. Drink plenty of water.
7. Train your muscles with Kegel exercises.

Full recovery occurs 2 months after the procedure. Pay attention to the photo of the incision during childbirth, it shows how it should look. You need to be careful about your he alth and if you have any ailments, consult a doctor. It is about complications that will be discussed further.

Consequences

Not everything goes as smoothly as we would like, and if an incision was made during childbirth and mistakes were made during the recovery period, there may be complications:

1. Swelling of the incision, which is treated with ice. It is superimposed on the incision site, an anesthetic is additionally applied.
2. Divergence of the seams can occur due to a sitting posture or heavy loads. In this case, new stitches are applied and the treatment process starts from scratch.
3. Infection in the wound, the treatment of which is possible only with antibiotics. If the conditions are favorable, then the stitches are removed and the wound drains, this is the removal of pus and fluid.
4. The appearance of a hematoma - in this case, you must immediately remove all stitches and clean the wound from pus, rinsedisinfectant, prescribe a course of antibiotics and begin treatment.
5. Pain during intercourse. This is an unpleasant, but quite normal feeling; women experience pain during the first three months during an intimate relationship. After about a year, there is a full recovery.

Reviews of patients and opinions of doctors

As we have understood, episiotomy is a necessary measure, which should not be resorted to if the birth is going well. Let's turn to the opinion of experts.

Gynecologists indicate that up to 45% of all births are accompanied by this obstetric operation, it is the safest and best option for complications in labor. An episiotomy is necessary and useful only when there are indications for it, it is strictly forbidden to do it just like that.

Reviews of many women in labor show that you need to talk with the obstetrician before the birth, discussing with him all the nuances and expressing your opinion regarding the obstetric operation. Often there are cases when doctors play it safe and do an episiotomy in cases where it is possible to do without it. Stay he althy and do not resort to another surgical intervention!