Episiotomy

ʻO kahi episiotomy kahi ʻoki liʻiliʻi e hoʻonui i ka wehe ʻana o ka ʻōpū i ka wā hānau. He ʻokiʻoki ia i ka perineum - ka ʻili a me nā mākala ma waena o ka hāhā a me ka anus.

Aia kekahi mau pilikia i ka loaʻa ʻana o ka episiotomy. Ma muli o nā pilikia, ʻaʻole like ka maʻamau o nā episiotomies e like me ka wā ma mua. Loaʻa nā pilikia i:

• E haehae paha ke ʻoki a nui aʻe i ka wā o ka lawe ʻana. Hiki i ka waimaka ke komo i loko o ka mākala a puni ke koloka, a i ʻole i loko o ka ʻūhā.
• Nui aʻe paha ka lilo o ke koko.
• ʻO ka ʻoki a me nā humuhumu e maʻi paha.
• He ʻeha paha ka moekolohe no nā mahina mua ma hope o ka hānau ʻana.

I kekahi manawa, hiki ke kōkua i kahi episiotomy me nā pilikia.

Nui nā wahine i ka hānau keiki me ka haehae ʻole iā lākou iho, a me ka ʻole o ka episiotomy. ʻO ka ʻoiaʻiʻo, nā hōʻike hou e hōʻike nei i ka loaʻa ʻole o ka episiotomy ka mea ʻoi loa no ka hapa nui o nā wahine i ka hana.

ʻAʻole hoʻōla maikaʻi nā Episiotomies ma mua o ka waimaka. Lōʻihi pinepine lākou e hoʻōla ma muli o ka ʻoki pinepine ʻana ma mua o kahi waimaka maoli. I nā kūlana ʻelua, pono e humuhumu ʻia ka ʻoki a i ʻole ka waimaka a mālama pono ʻia ma hope o ka hānau ʻana. I kekahi manawa, pono paha kahi episiotomy e hōʻoia i ka hopena maikaʻi loa nāu a me kāu pēpē.

• Kaumaha ka hana no ka pēpē a pono e hoʻopōkole ʻia ka pae hoʻokū e hoʻēmi ai i nā pilikia no ka pēpē.
• Nui loa ke poʻo a me nā poʻohiwi o ka pēpē no ka wehe ʻana o ka ʻōpū o ka makuahine.
• Aia ke pēpē i kahi kūlana breech (nā wāwae a i ʻole nā ​​ʻūlū e hele mua ana) a aia kahi pilikia i ka wā o ka hānau ʻana.
• Pono pono nā mea kani (forceps a i ʻole ka huki huki) e kōkua i ka lawe ʻana i ka pēpē i waho.

Ke hoʻokeke nei ʻoe ma ke kokoke o ke poʻo o ke pēpē e puka i waho, a ke hele nei kahi waimaka i kahi o ka urethral.

Ma mua o ka hānau ʻia ʻana o kāu pēpē a ʻoiai e kokoke ana ke poʻo o ke poʻo i ke kalaunu, e hāʻawi aku kāu kauka a i ʻole ka paleke iā ʻoe i kahi kīnā e numb i ka wahi (inā ʻaʻole i loaʻa iā ʻoe kahi epidural).

A laila, hana ʻia kahi ʻoki liʻiliʻi (ʻoki). Aia he ʻelua ʻano ʻoki: median a me mediolateral.

• ʻO ka incision median ka ʻano maʻamau. He ʻoki pololei ia i waenakonu o ka wahi ma waena o ka lua a me ka anus (perineum).
• Hana ʻia ka ʻokiʻoki mediolateral i kahi kihi. ʻAʻole hiki ke haehae i ka anus, akā ʻoi aku ka lōʻihi o ka hoʻōla ma mua o ka ʻoki waena.

Hāʻawi kāu mea mālama ola i ka pēpē ma o ka wehe ākea.

A laila, hāʻawi kāu mea hāʻawi i ka placenta (ma hope o ka hānau ʻana). A laila e humuhumu ʻia ka ʻoki.

Hiki iā ʻoe ke hana i nā mea e hoʻoikaika ai i kou kino no ka hana e hoʻohaʻahaʻa ai i kou manawa e pono ai i kahi episiotomy.

• Hoʻomaʻamaʻa i nā hoʻoikaika kino Kegel.
• Hana i ka massage perineal ma ka 4 a 6 mau pule ma mua o ka hānau ʻana.
• E hoʻomaʻamaʻa i nā ʻenehana āu i aʻo ai i ka papa hānau keiki e kāohi ai i kou hanu ʻana a me kou makemake e kaomi.

E noʻonoʻo, ʻoiai ʻoe e hana i kēia mau mea, pono paha ʻoe i kahi episiotomy. E hoʻoholo kāu mea hāʻawi inā pono kāu e hoʻokumu i kahi mea e hana ai i kāu hana.

Hana - episiotomy; Hāʻawi i ka maʻi ʻōpū - episiotomy

• Episiotomy - moʻo

ʻO Baggish MS. Episiotomy. I: Baggish MS, Karram MM, eds. Nā Atlas o ka Pelvic Anatomy a me nā ʻōpala Gynecologic. ʻEhā ed. Piladelapia, PA: Elsevier; 2016: chap 81.

Kilpatrick SJ, Garrison E, Fairbrother E. Ka hana maʻamau a me ka lawe ʻana. I: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Nā Kāpena Gabbe: Nā Pregnancies Maʻamau a me nā Pilikia. 8th ed. Piladelapia, PA: Elsevier; 2021: chap 11.

• Hānau keiki