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Re: Median vs. medio-lateral episiotomy.From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au)Sun Jun 24 17:49:09 2007
Never lose sight of the fact that routine episiotomy is unwarranted - and that means with vacuums and forceps also. There have been many occasions in my experience where no episiotomy was necessary with assisted delivery. One should always wait until the perineum is distended and white, and then perform the smallest episiotomy that is required to allow the head to pass. If you do a J-shaped one the problem in sewing it up is getting it done without distortion. Even a medio-lateral incision can tear sideways into the rectum so it is no guarantee of safety. Steve -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Saturday, 23 June 2007 10:50 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Median vs medio-lateral episiotomy. Good discussion, and I do seem to find good luck with a small nick as the head crowns that I can control the head. Dan, are you saying make a bigger one (i.e. the more traditional method to which you refer) for forceps, vacuums, or whenever you feel that you need one? Dan could be right and we've all just been lucky. . . Garry
At Sat, 23 Jun 2007, Paul André Latulippe wrote:
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