Managing Complications in Pregnancy and Childbirth: - IAWG

P-74 Episiotomy- At the opening of the vagina, bring together the cut edges ofthe vaginal opening;- Bring the needle under the vaginal opening and out throughthe incision and tie.• Close the perineal muscle using interrupted 2-0 sutures (FigP-41 B).• Close the skin using interrupted (or subcuticular) 2-0 sutures (FigP-41 C).FIGURE P-41Repair of episiotomyCOMPLICATIONS• If a haematoma occurs, open and drain. If there are no signs ofinfection and bleeding has stopped, reclose the episiotomy.• If there are signs of infection, open and drain the wound. Removeinfected sutures and debride the wound:- If the infection is mild, antibiotics are not required;- If the infection is severe but does not involve deep tissues, givea combination of antibiotics (page C-35):- ampicillin 500 mg by mouth four times per day for 5 days;