Episiotomía: Procedimiento a elección y no de rutina

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Abstract

La episiotomía es una incisión que secciona el periné. Se usa para ampliar el canal de parto en mujeres que viven un parto vaginal por primera vez. Actualmente su utilización se ha puesto en duda, ¿es realmente necesaria? Existe evidencia que indica que la mujer no debería ser sometida a esta técnica. Además de ser una práctica invasiva, esta podría tener complicaciones muy serias en el puerperio de la paciente. A nivel mundial se están realizando estudios sobre nuevas técnicas como el masaje del periné pre parto, entre otras. Todo esto para evitar en un futuro la práctica de la episiotomía.

Translated abstract

An episiotomy is an incision that cuts the perineum. It is used to enlarge the birth canal in women living a vaginal birth for the first time. Currently its use has been questioned, is it really necessary? Evidence suggests that women should not be subjected to this technique. Besides being an invasive practice, this could have very serious complications in the postpartum patient. Globally, studies are underway on new techniques such as pre childbirth perineal massage, among others. All this to avoid in the future the practice of episiotomy.

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Most cited references 19

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Classification of episiotomy: towards a standardisation of terminology.

D G Tincello, Pia Laine, J. Carvalho … (2012)

Seven episiotomy incisions are described in the literature, although only midline, mediolateral or lateral episiotomies are commonly used. Recent research has demonstrated variations in both site and direction of the incision, and differences between the angle of incision at the time of crowning of the fetal head and the angle of the scar once the wound has been repaired. We review this evidence and suggest that this variation may undermine the reliability of much published work. We suggest a standardised definition of each type of episiotomy to establish uniformity going forward, so that future studies are amenable to comparison and meta-analysis. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

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Hyaluronidase for reducing perineal trauma.

Fan Zhou, Xiao Wang, Jing. Li … (2014)

Perineal hyaluronidase (HAase) injection was widely used to reduce the occurrence of perineal trauma, pain and need for episiotomy in the 1950s to 1960s. Reports suggested that the administration of HAase was a simple, low risk, low cost and effective way to decrease perineal trauma without adverse effects.