Managing Complications in Pregnancy and Childbirth: - IAWG

EpisiotomyFIGURE P-40Making the incision while inserting two fingers toprotect the baby’s headP-73REPAIR OF EPISIOTOMYNote: It is important that absorbable sutures be used for closure.Polyglycolic sutures are preferred over chromic catgut for theirtensile strength, non-allergenic properties and lower probabilityof infectious complications and episiotomy breakdown. Chromiccatgut is an acceptable alternative, but is not ideal.• Apply antiseptic solution to the area around the episiotomy (pageC-22).• If the episiotomy is extended through the anal sphincter or rectalmucosa, manage as third or fourth degree tears, respectively (pageP-86).• Close the vaginal mucosa using continuous 2-0 suture (Fig P-41 A,page P-74):- Start the repair about 1 cm above the apex (top) of theepisiotomy. Continue the suture to the level of the vaginalopening;