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Episiotomía - Overview

Definición:

Es un procedimiento en el cual se corta la piel entre la vagina y el ano, un área llamada perineo. La episiotomía se practica ocasionalmente con el fin de agrandar la abertura vaginal, de tal manera que un bebé pueda salir más fácilmente.

Descripción:

Justo antes de que nazca el bebé, el obstetra insensibiliza la abertura del área vaginal y hace uno de dos cortes:

  • Un corte medio lateral en ángulo hacia abajo lejos de la vagina y dentro del músculo.
  • Un corte medio derecho hacia abajo entre la vagina y el ano.

El corte hace que la abertura vaginal se agrande. Dicho corte se cierra con suturas después de que haber sacado el bebé y la placenta.

Por qué se realiza el procedimiento:

Las episiotomías alguna vez se realizaban en forma rutinaria para prevenir desgarros vaginales durante el parto, pero en la actualidad no se recomiendan.

Sin embargo, las episiotomías aún se pueden llevar a cabo cuando haya un parto complicado. Una episiotomía puede ser necesaria si la cabeza o los hombros del bebé son demasiado grandes para la abertura vaginal de la madre o si el bebé viene en presentación o parto de nalgas (pies y glúteos vienen primero) y hay un problema durante el parto.

También puede ser necesaria para acelerar el proceso del parto si hay preocupación acerca de la frecuencia cardíaca del bebé.

  • Reviewed last on: 9/2/2009
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA. 2005;293(17):2141-2148.

American College of Obstetricians-Gynecologists. Episiotomy. Clinical Management Guidelines for Obstetrician-Gynecologists. ACOG Practice Bulletin. 2006;71.

Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database of Systematic Reviews. 2009;1:CD000081.

Frankman EA, Wang L, Bunker CH, Lowder JL. Episiotomy in the United States: has anything changed? Am J Obstet Gynecol. 2009;200:573.e1-573.e7.

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