Episiotomy

EPISIOTOMY

Q. 1

Scar endometriosis can occur following :

 A

Classical Cesarean Section

 B

Hysterotomy

 C

Episiotomy

 D

All of the above

Q. 1

Scar endometriosis can occur following :

 A

Classical Cesarean Section

 B

Hysterotomy

 C

Episiotomy

 D

All of the above

Ans. D

Explanation:

Ans. is d i.e. All of the above                   

Endometriosis sometimes occurs in abdominal wall scars following operations on uterus or tubes and is known as Scar endometriosis.

Operations most likely to be followed by scar endometriosis

  • Hysterotomy°                                                                               • Classical cesarean section°
  • Myomectomy°                                                                              • Ventrofixation°
  • Following operations for section of Fallopian tube°                    • Following operations for removal of pelvic
  • Episiotomy°                                                                                     endometriosis°

Q. 2

A primipara is in labor and an episiotomy is about to be cut. Compared with a midline episiotomy, an advantage of mediolateral episiotomy is:

 A

Ease of repair

 B

Fewer breakdowns

 C

Less blood loss

 D

Less extension of the incision

Q. 2

A primipara is in labor and an episiotomy is about to be cut. Compared with a midline episiotomy, an advantage of mediolateral episiotomy is:

 A

Ease of repair

 B

Fewer breakdowns

 C

Less blood loss

 D

Less extension of the incision

Ans. D

Explanation:

Midline episiotomies are easier to fix and have a smaller incidence of surgical breakdown, less pain, and lower blood loss. The incidence of dyspareunia is somewhat less. However, the incidence of extensions of the incision to include the rectum is considerably higher than with mediolateral episiotomies. 

  Type of Episiotomy Type of Episiotomy
Characteristic Midline Mediolateral
Surgical repair Easy More difficult
Faulty healing Rare More common
Postoperative pain Minimal Common
Anatomical results Excellent Occasionally faulty
Blood loss Less More
Dyspareunia Rare Occasional
Extensions Common Uncommon

Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 17. Normal Labor and Delivery. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.


Q. 3

Most suitable method of treating 4 inch size episiotomy hematoma is by :

 A

Evacuation

 B

Magsulf compression

 C

Cold compress

 D

Marsupialisation

Q. 3

Most suitable method of treating 4 inch size episiotomy hematoma is by :

 A

Evacuation

 B

Magsulf compression

 C

Cold compress

 D

Marsupialisation

Ans. A

Explanation:

Evacuation


Q. 4

The most important step in the treatment of a badly infected episiotomy is :

 A

Securing cultures

 B

Antibiotics

 C

Hot sitz baths

 D

Drainage

Q. 4

The most important step in the treatment of a badly infected episiotomy is :

 A

Securing cultures

 B

Antibiotics

 C

Hot sitz baths

 D

Drainage

Ans. D

Explanation:

Drainage


Q. 5

Episiotomy is best done :

 A

Medially

 B

Laterally

 C

Mediolaterally

 D

J shaped

Q. 5

Episiotomy is best done :

 A

Medially

 B

Laterally

 C

Mediolaterally

 D

J shaped

Ans. C

Explanation:

Mediolaterally


Q. 6

Advantages of median episiotomy over mediolateral episiotomy are all except:      

March 2005

 A

Less blood loss

 B

Easy repair

 C

Extension of the incision is easy

 D

Muscles are not cut

Q. 6

Advantages of median episiotomy over mediolateral episiotomy are all except:      

March 2005

 A

Less blood loss

 B

Easy repair

 C

Extension of the incision is easy

 D

Muscles are not cut

Ans. C

Explanation:

Ans. C: Extension of the Incision is Easy

Mediolateral episiotomy is performed by making a diagonal incision across the midline between the vagina and anus This method is used much less often.

The disadvantages are:

  • Apposition of the tissues is not so good.
  • May require more healing time than the midline incision.
  • Blood loss is little more
  • Postoperative discomfort is more
  • Relative increased incidence of wound disruption
  • Dyspareunia is comparatively more

The advantages are:

  • If necessary the incision can be extended.
  • Relative safety from rectal involvement from extension.


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