{"id":1758,"date":"2010-12-14T07:31:29","date_gmt":"2010-12-14T07:31:29","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/performing-a-mediolateral-episiotomy\/"},"modified":"2023-09-20T09:56:57","modified_gmt":"2023-09-20T08:56:57","slug":"performing-a-mediolateral-episiotomy","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/obstetrics\/management-of-childbirth\/performing-a-mediolateral-episiotomy\/","title":{"rendered":"Performing A Mediolateral Episiotomy"},"content":{"rendered":"<h3><span style=\"text-decoration: underline;\"><span style=\"color: #003366;\"><strong>How To Perform A Mediolateral Episiotomy<\/strong><\/span><\/span><\/h3>\n<hr \/>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124023584?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Check that the anaesthetic has taken sufficient effect by carefully sticking the <span style=\"color: #33cccc;\"><strong>hypodermic needle<\/strong><\/span> in the <span style=\"color: #33cccc;\"><strong>perineal pathway<\/strong><\/span> of the episiotomy.<\/span><\/li>\n<li><span style=\"color: #003366;\">Using two fingers of the left hand protect the head of the foetus, whilst inserting a <span style=\"color: #33cccc;\"><strong>blade<\/strong><\/span> of the <span style=\"color: #33cccc;\"><strong>episiotomy scissors<\/strong><\/span> into the vagina <em><strong>[Figure 37]<\/strong><\/em>. Whilst performing the episiotomy, the scissors or the scalpel should be set <span style=\"color: #33cccc;\"><strong>perpendicular<\/strong><\/span> to the tissue.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1756\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Obstetrics_ob-fig-37.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Obstetrics_ob-fig-37.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Obstetrics_ob-fig-37-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 37<\/span><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Start the episiotomy from the <span style=\"color: #33cccc;\"><strong>median line<\/strong><\/span>. In the case of the <span style=\"color: #33cccc;\"><strong>mediolateral episiotomy<\/strong><\/span> in particular, there is a tendency to glide away laterally with the scissors <em><strong>[Figure 38]<\/strong><\/em>. In general, this leads to a wound that is more difficult to suture and there is a greater risk of <span style=\"color: #33cccc;\"><strong>dyspareunia<\/strong><\/span>. Also, if the incision is started too laterally, there is a risk of damaging the <span style=\"color: #33cccc;\"><strong>Bartholin\u2019s<\/strong> <strong>duct<\/strong><\/span>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1757\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Obstetrics_ob-fig-38.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Obstetrics_ob-fig-38.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Obstetrics_ob-fig-38-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 38<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Cut or incise the <span style=\"color: #33cccc;\"><strong>perineum<\/strong><\/span>, <span style=\"color: #33cccc;\"><strong>vagina<\/strong><\/span>, and the <span style=\"color: #33cccc;\"><strong>tissue in between<\/strong><\/span>, in the desired direction and to the desired depth. An episiotomy does not need to have a standard size, but can be performed to satisfy the desired measurements. A small episiotomy can provide an excellent result whilst at the same time causing far less damage.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>How To Perform A Mediolateral Episiotomy Procedure Check that the anaesthetic has taken sufficient effect by carefully sticking the hypodermic needle in the perineal pathway of the episiotomy. Using two fingers of the left hand protect the head of the foetus, whilst inserting a blade of the episiotomy scissors into the vagina [Figure 37]. Whilst [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[58],"tags":[138],"class_list":["post-1758","post","type-post","status-publish","format-standard","hentry","category-management-of-childbirth","tag-obstetrics"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Performing A Mediolateral Episiotomy - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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