Obstetric and Gynecological Nursing - The Carter Center

4.4. Episiotomy
Definition: The making of an incision into the prenium to
enlarge the vaginal orifice.
Indications for Episiotmy
1. Delay due to rigid perineum, disproportion between fetus
and vaginal orifice.
2. Fetal distress due to prolapsed cord in second stage.
3. To facilitate vaginal or intra uterine manipulation
Eg. Forceps, breach delivery
4. Preterm baby in order to avoid intracranial damage
5. Previous 3 rd degree repaired on the perineum.
Advantages of episiotomy
1. Fetal acidosis and hypoxia are reduced
2. Over stretching of the pelvic floor is lessened
3. Bruising of the urethra is avoided.
4. In sever pre – eclampsia or cardiac disease to reduce the
effort bearing down.
5. A previous third degree tear which may occur again
because of the scar tissue which does not stretch well is
prevented.
Types of Episiotomy
1. Medio- lateral
2. Median
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