Re: Median vs. medio-lateral episiotomy.
From: Meenan, Anna (annam@uic.edu)
Sun Jun 24 19:29:35 2007
I'm with you Steve.
Anna Meenan, MD
>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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>>Hi
>>
>>I worked in France and I make the median
>>episiotomy. I received many criticisms on this
>>subject. But, often, when the perineum is near to
>>tear, a small median notch makes it possible to
>>direct the tear with less damage than the traditional episiotomy.
>>
>>Le 01:27 06/23/2007, vous avez écrit:
>>>As a matter of fact, in this country small nicks
>>>are called "episio de sage-femme" (midwife's epis).
>>>Bernard
>>>
>
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