An episiotomy is a surgically planned incision made in the perineum and posterior vaginal wall during the second stage of labor. It is done to enlarge the vaginal opening to facilitate delivery, minimize tearing of the vagina and perineal tissues, and reduce stress on the fetal head. The ideal time for an episiotomy is when 3-4 cm of the baby's head is visible. A mediolateral incision is most common, starting at the midpoint of the vaginal opening and extending diagonally away from the anus. An episiotomy can benefit both mother and baby by allowing for an easier delivery and reducing maternal and fetal injuries.
Partograph is a composite graphical recording of progress of labour and salient condition of mother and fetus. For progress of labor and conditions of the mother and the fetus. It was developed and extensively tested by the world health organization (WHO)
Definitions
Stages and Phases of Normal Labour
Abnormal Patterns of Labour
Classification of Abnormal Labour/Dystocia
Diagnosis and Management of Abnormal Labour
Partograph is a composite graphical recording of progress of labour and salient condition of mother and fetus. For progress of labor and conditions of the mother and the fetus. It was developed and extensively tested by the world health organization (WHO)
Definitions
Stages and Phases of Normal Labour
Abnormal Patterns of Labour
Classification of Abnormal Labour/Dystocia
Diagnosis and Management of Abnormal Labour
Normal puerperium - Obstetrical and Gynecological NursingJaice Mary Joy
The word puerperium is originated from the Latin words ‘puer’ – child and ‘pams’ – bringing forth.
Also known as the post-partum, post-natal, or post-delivery period.
The mother during puerperium is termed as puerpera.
A vasectomy (male sterilisation) is a surgical procedure to cut or seal the tubes that carry a man's sperm to permanently prevent pregnancy.
It's usually carried out under local anaesthetic, where you're awake but don't feel any pain, and takes about 15 minutes.
In rare cases, you may have a general anaesthetic, where you're asleep during the operation.
An episiotomy is a cut (incision) through the area between your vaginal opening and your anus. This area is called the perineum. This procedure is done to make your vaginal opening larger for childbirth.
Normal puerperium - Obstetrical and Gynecological NursingJaice Mary Joy
The word puerperium is originated from the Latin words ‘puer’ – child and ‘pams’ – bringing forth.
Also known as the post-partum, post-natal, or post-delivery period.
The mother during puerperium is termed as puerpera.
A vasectomy (male sterilisation) is a surgical procedure to cut or seal the tubes that carry a man's sperm to permanently prevent pregnancy.
It's usually carried out under local anaesthetic, where you're awake but don't feel any pain, and takes about 15 minutes.
In rare cases, you may have a general anaesthetic, where you're asleep during the operation.
An episiotomy is a cut (incision) through the area between your vaginal opening and your anus. This area is called the perineum. This procedure is done to make your vaginal opening larger for childbirth.
Partograph is composite graphical record of key data (maternal & fetal) during labour, entered against time on a single sheet of paper.
A surgical planned incision on the perineum and the posterior vaginal wall during the second stage of labour is called episiotomy (perineotomy).
An episiotomy is a surgical procedure to widen the opening of the vagina during childbirth.
During labor, your perineum — the skin and muscles between your vagina and anus — will be numbed with a shot, if you haven't already been given an epidural.
Then, a small, straight incision will be made in the middle of the perineum.
Alternatively, the incision may be made at an angle — a cut that is less likely than a straight incision to tear through the anus, but may take longer to heal.
Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician. Episiotomy is usually performed during second stage of labor to quickly enlarge the opening for the baby to pass through.
LSCS is the most common obstetric procedure but it can be very difficult to manage in cases of previous LSCS, low lying placenta, and PPH. please check out the youtube links to the videos embedded in this PPT.
ADHESIOLYSIS DURING LSCS https://youtu.be/2Hv80v3yu20
BLADDER DISSECTION https://youtu.be/6qsaTJ1yRUY
RECTUS SHEATH ADHESIOLYSIS https://youtu.be/SryJHjuGsME
VECTIS IN FLOATING HEAD DURING LSCS https://youtu.be/3PECperU8Cw
BREECH DELIVERY https://youtu.be/i-LcmTNNVvU
TRANSVERSE LIE WITH IUFD https://youtu.be/hG28uqpkdpU
CONJOINT TWINS https://youtu.be/KLR7D6wkf38
LSCS IN PLACENTA PREVIA https://youtu.be/dNKQwt4KhVY
SYSTEMATIC PELVIC DEVASCULARISATION https://youtu.be/UwSH6V6GBVw
Episiotomy slideshare by dr alka mukherjee & dr apurva mukherjee msalka mukherjee
Normal birth can cause tears to the vagina and the surrounding tissue, usually as the baby's head is born, and sometimes these tears extend to the rectum. These are repaired surgically, but take time to heal. To avoid these severe tears, it is recommended making a surgical cut to the perineum with scissors or scalpel to prevent severe tearing and facilitate the birth. This intervention, known as an episiotomy, is used as a routine care policy during births in some countries. Both a tear and an episiotomy need sutures, and can result in severe pain, bleeding, infection, pain with sex, and can contribute to long term urinary incontinence.
Episiotomies—incisions made between the vagina and anus during childbirth—have long been a topic of debate among clinicians, researchers and advocates. Outdated clinical guidelines previously recommended the routine use of episiotomy to avoid natural vaginal tearing. Over the past two decades, a growing body of literature and increased advocacy efforts have led to a general consensus that episiotomy should not be conducted as a standard practice. Nevertheless, in many parts of the world, the majority of women still undergo episiotomy during childbirth.
In women where no instrumental delivery is intended, selective episiotomy policies result in fewer women with severe perineal/vaginal trauma.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
2. DEFINITION
A surgically planned incision on the perineum and the
posterior vaginal wall during the second stage of labor
is called episiotomy or perineotomy.
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3. OBJECTIVE
To cut short the second stage of labor.
To enlarge introitus (vaginal opening) in order to
facilitate easy delivery of baby.
To minimize over stretching and rupture of vagina,
perineal muscles and fascia.
To reduce stress on fetal head.
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4. INDICATIONS
In elastic (rigid) perineum.
Anticipating perineal tear.
Operative delivery
Previous perineal surgery.
Threatened perineal injury in primi gravidae.
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5. TIMING OF EPISIOTOMY
Bulging thinned perineum during contraction just
prior to crowning (when 3-4 cm of head is visible) is
the ideal time.
If done early- chances of blood loss.
If done late – fails to prevent the invisible lacerations
of perineal body.
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6. ADVANTAGES
Maternal
A clear & controlled incision is easy to repair and heals
better than a lacerated wound
Reduction in the duration of second stage of labor.
Reduction of trauma to the pelvic floor muscles that
reduces the incidence of prolapse and perhaps urinary
incontinance.
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7. ADVANTAGES
Fetal
It minimizes intracranial injuries specially in
premature babies or after coming head of breech.
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8. TYPES OF EPISIOTOMY
Median
Medio-lateral
Lateral
J-shaped
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9. Median
The incision commences from the centre of the
fourchette and extends on the posterior side along the
midline for 2.5 cm (1 in).
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10. Medio-lateral
The incision is made downward and outward from the
midpoint of the fourchette either to the right or left. It
is directed diagonally in a straight line which runs
about 2.5 cm (1 in) away from the anus (midpoint
between the anus and the ischial tuberosity).
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11. Lateral
The incision starts from about 1 cm (0.4 in) away from
the centre of the fourchette and extends laterally.
Drawbacks include the chance of injury to the
Bartholin's duct, therefore some practitioners have
strongly discouraged lateral incisions.
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12. J-shaped
The incision begins in the centre of the fourchette and
is directed posteriorly along the midline for about 1.5
centimetres (0.59 in) and then directed downwards
and outwards along the 5 or 7 o'clock position to avoid
the internal and external anal sphincter. This
procedure is also not widely practised.
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