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Vaginal tears can occur during childbirth, most often at the introitus as the baby's head passes through, especially if the baby descends quickly. Episiotomies are used in an effort to prevent soft-tissue tearing (perineal tear) which may involve the anal sphincter and rectum. Tears can involve the perineal skin or extend to the muscles and the ...
Antenatal perineal massage (APM) or Birth Canal Widening (BCW) is the massage of a pregnant woman's perineum – the skin and deep tissues around the opening to the vagina (or 'birth canal' – when a baby is in this passage), performed in the 4 to 6 weeks before childbirth, i.e., 34 weeks or sooner (Reference 7, as more births are occurring at around 28 weeks) and continued weekly until birth.
[6] [7] It may also prevent the bearing down reflex during a contraction, therefore it should not be used too early in labor. [8] It can also be used for pain relief from episiotomy or perineal lacerations [6] [8] Pudendal anesthesia is used during operative vaginal delivery which includes the use of forceps. [7]
The fourchette may be torn during delivery due to the sudden stretching of the vulval orifice, or during copulation. To prevent this tearing in a haphazard manner, obstetricians and, less frequently, midwives may perform an episiotomy, which is a deliberate cut made in the perineum starting from the fourchette and continuing back along the perineum toward the anus.
Shoulder dystocia occurs after vaginal delivery of the head, when the baby's anterior shoulder is obstructed by the mother's pubic bone. [3] [1] It is typically diagnosed when the baby's shoulders fails to deliver despite gentle downward traction on the baby's head, requiring the need of special techniques to safely deliver the baby. [2]
Injury to the perineum or surgical cuts to the vagina during childbirth can cause sexual dysfunction. Sexual activity in the postpartum period other than sexual intercourse is possible sooner, but some women experience a prolonged loss of sexual desire after giving birth, [ 2 ] which may be associated with postnatal depression .
A perineal tear is a laceration of the skin and other soft tissue structures which, in women, separate the vagina from the anus. Perineal tears mainly occur in women as a result of vaginal childbirth, which strains the perineum. It is the most common form of obstetric injury. [1] Tears vary widely in severity.
The perineal approach uses a small incision in the perineum between the anus and the ischial tuberosity. The nerve is freed within the pudendal canal. [10] The laparoscopic approach (Istanbul technique), also termed "laparoscopic pudendal nerve decompression and transposition with omental fap protection of the nerve," is relatively new.
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