Re: Median vs. medio-lateral episiotomy.
From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au)
Mon Jun 25 18:07:51 2007
Absolutely. I see a nice clean episiotomy after the head passes through only to be surprised by the extra tear after the shoulders are out!
Steve
________________________________
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Henry =
--
________________________________
Gregor
Sent: Tuesday, 26 June 2007 8:08 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Median vs. medio-lateral episiotomy.
H'mm...less than the head, the problem often seems, to me, to be the posterior shoulder that puts the stress on the perineum that in turn leads to tears. Comments?
H
Raymond Stephen <stephen.raymond@dhhs.tas.gov.au> wrote:
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:
>
>--Boundary_(ID_lqNLgZ89hcphD9D3Uvc03Q)
>Content-type: text/plain; charset=iso-8859-1; format=flowed
>Content-transfer-encoding: quoted-printable
>
>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
>>
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose.
________________________________
Expecting? Get great news right away with email Auto-Check. =
________________________________
<http://us.rd.yahoo.com/evtI982/*http:/advision.webevents.yahoo.com/mailbeta/newmail_tools.html>
Try the Yahoo! Mail Beta. <http://us.rd.yahoo.com/evtI982/*http:/advision.webevents.yahoo.com/mailbeta/newmail_tools.html>
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose.
