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Re: ?? Elective Episiotomy From: Tonya Von Brooks, CPM (nbwc@ix.netcom.com) Thu Mar 25 01:28:42 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard W Lisse: "Re: cord prolapse / Foley & bladder distention (was Em Anes for" Previous message: Tonya Von Brooks, CPM: "Re: Ecological HRT" Maybe in reply to: Sue Turner: "?? Elective Episiotomy" Next in thread: Braun, R. Daniel: "Re: ?? Elective Episiotomy" Jane ,I also read your article after Bob posted the reference .It was a really nice study-You should have shared! I also agree with you . No episotomy and like Kathy posted a left lateral position for delivery might help.Tonya Brooks Jane Helwig, MD wrote: > At Wed, 24 Mar 1999, D.Ingham RM wrote: > > > >A lady in my care, G3P2, is now 30/52 gestation. During her first > >delivery she had an episiotomy and a further 3rd degree tear (involving > >anal sphincter and taking six months to heal) For her second delivery > >her OB advised an elective episiotomy, which was done but she also had a > >tear along the previous tear site, although not 3rd degree. She is now > >keen to avoid another episiotomy. Is an elective episiotomy advisable > >again? > >thanks > >Debbie > > Agree with Bob, Kathi, and Garry. > > I have taken care of many patients with one or more previous > episiotomies, some with previous 3rd or 4th degree extensions, who did > not want repeat episiotomies. Virtually all of them have delivered > without an episiotomy. So far, I have never seen one of these patients > have a 3rd or 4th degree tear. It is common to see 2nd degree > lacerations, but a fair number deliver over an intact perineum. > > It is a benefit in these cases that the patient is now a multip and thus > less likely to require operative delivery, itself a risk factor for > perineal lacerations. (Although, as Bob knows, I don't believe > operative delivery requires episiotomy.) > > Jane > > -- > Jane Helwig, MD > Private practice > Nassawadox, VA Next message: Dr Eberhard W Lisse: "Re: cord prolapse / Foley & bladder distention (was Em Anes for" Previous message: Tonya Von Brooks, CPM: "Re: Ecological HRT" Maybe in reply to: Sue Turner: "?? Elective Episiotomy" Next in thread: Braun, R. Daniel: "Re: ?? Elective Episiotomy"

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