OB-GYN-L Messages for February, 2008: Re: Episiotomy question

Re: Episiotomy question

From: FRANCES WREN

fwren@shaw.ca

Sat Feb 16 21:56:02 2008

I had a colleague who would do a 4th degree epis if he used forceps ...and thought he needed a big cut...but I myself have never meant to "arrive " at a 4th degree...always inadvertently...and never happy when if it happened....in fact if I thought it might then sometimes i would opt for a medio-lateral epis. frances wren

>----- Original Message -----
From: DoctorJoe@aol.com Date: Saturday, February 16, 2008 6:24 pm Subject: Re: Episiotomy question To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>

>
> In a message dated 2/16/08 1:10:57 PM, clairec1979@hotmail.com writes:
>
> > I've had a woman tell me that on her previous birth she had a
> 4th degree
> > episiotomy (going for elective section this time). I assumed
> she meant
> > she had an episiotomy which extended to 4th degree, however
> she stated
> > that she heard the OB say that he was going to have to cut a
> 4th degree
> > episiotomy.
> >
> > Does this sound right? I can't imagine any circumstance where you'd
> > actually have to cut through the anal sphincter, if any of you
> have had
> > to do this could you explain the situation.
> >
>
> It's the old theory (right or wrong, you can argue it) that it's
> better to
> cut a primary incision than to "let'er rip!" So if you
> anticipate a LARGE
> extension, you cut it first, to make it easier to repair, keep
> the layers straight,
> etc.
>
> Joe P.
>

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<DIV>I had a colleague who would do a 4th degree epis if he used forceps ...and thought he needed a big cut...but I myself have never meant to "arrive " at a 4th degree...always inadvertently...and never happy when if it happened....in fact if I thought it might then sometimes i would opt for a medio-lateral epis.</DIV> <DIV>frances wren</DIV> <DIV> </DIV>

><DIV> ----- Original Message ----- From: DoctorJoe@aol.com Date: Saturday, February 16, 2008 6:24 pm Subject: Re: Episiotomy question To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net> > > In a message dated 2/16/08 1:10:57 PM, clairec1979@hotmail.com writes: > > > > I've had a woman tell me that on her previous birth she had a > 4th degree > > episiotomy (going for elective section this time).  I assumed > she meant > > she had an episiotomy which extended to 4th degree, however > she stated > > that she heard the OB say that he was going to have to cut a > 4th degree > > episiotomy. > > > > Does this sound right? I can't imagine any circumstance where you'd > > actually have to cut through the anal sphincter, if any of you > have had > > to do this could you explain the situation. > > > > It's the old theory (right or wrong, you can argue it) that it's > better to > cut a primary incision than to "let'er rip!" So if you <
;BR>> anticipate a LARGE > extension, you cut it first, to make it easier to repair, keep > the layers straight, > etc. > > Joe P. > > > > > to-please-your-picky- > eater/rachel-campos-duffy/ ----7dc1d27431b24d738d3--

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