Care of the perineum Flashcards Preview

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Flashcards in Care of the perineum Deck (15)
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1
Q

What is the perineum?

A

Part of the pelvic floor- made up of the perineal muscle and body

2
Q

What percent of women sustained perineal trauma?

A

85% (2005)

3
Q

What is a first degree?

A

skin and/or vaginal mucosa

4
Q

What is a second degree?

A

injury to the perineum involving perineal muscle

5
Q

What is a third?

A

injury to the perineum involving the anal sphincter

6
Q

What is a 3A?

A

3A:<50% of the external anal sphincter
3B: >50%external anal sphincter
3C: both EAS and internal anal sphincter

7
Q

What is a 4th degree?

A

injury to the perineum including EAS IAS and anorcetal mucosa

8
Q

What does OASIS stand for

A

Obstetric Anal Sphincter Injurys

9
Q

Risk Factors for perineal trauma?

A
Asian ethnicity 
Prev 3/4th 
Prolonged 2nd stage 
Instrumental 
Shoulders 
BWT >4kg
OP
10
Q

Prevention think PEACHES?

A
Postion
Extra midwife 
Assess at all time
Communication 
Hands on
Episiotomy 
Slowly 

Warm compress 2nd stage
Perineal massage

11
Q

When should episiotomy be considered?

A

instrumental
imminent 3/4th degree tear
fetal destress

12
Q

How to assess for a tear?

A
analgesia
structures involved 
apex of injury 
PR exam 
bleeding
13
Q

Postnatal care…

A
prophylaxtic abx
laxitives 
analgesia 
perineal hygiene
pelvic floor
examine PN check
follow up 6-8weeks - if any pain or incontinence ref gynaecologist 
fully inform woman
14
Q

Effects of tear?

A
poor birth experience 
PND
infection 
sex
incontinence
15
Q

prognosis for women?

A

60-80% asymptomatic at 12months