- Make it generous.
- Or it may not be of any use.
Repair
- Suture of the vaginal portion is not needed
- Unless to stop bleeding
- Close the perineal wound only
- Make every effort to achieve exact realignment of the introitus
Tag: EPISIOTOMY
SHOULDER DYSTOCIA
- Do not panic
- Do not use forceful traction on head
- May cause severe damage to both child and mother
- Go systematically through following steps:
- Wipe baby’s face clean
- Keep airways free
- Use suction to remove mucus and meconium
- Make a generous episiotomy.
- This alone might solve the problem
- Apply Loevset’s maneuver
- Grasp lateral border of the scapula with four ulnar fingers of your hand
- Rotate truncus 180°
- Use right hand when the back is turned to the (mother’s) left and vice versa
- As the birth canal is shorter anteriorly bringing the posterior shoulder anteriorly may deliver it
- Repeat the maneuver
- Fracture both clavicles
- Decreases the overall dimension of the shoulders
- Place the delivery hook under one axilla
- Apply traction
- Rotate truncus 180° (Loevset’s Maneuver)
- Perform symphysiotomy
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