Sınırlı Epizyotomi İçin Klinik Değerlendirme Yöntemleri

Öz

Epizyotomi, zor doğumları kolaylaştırmak ve doğum kanalını genişletmek için perinede bulunan bulbokavernos kasa yapılan cerrahi kesi işlemidir. Epizyotominin rutin olarak yapılmaması gerektiği konusunda artık evrensel bir fikir birliği bulunmaktadır. ACOG, epizyotominin gerekli olduğu belirli bir durum olmadığını, epizyotomi kararı klinik değerlendirme yapılması gerektiğini belirtmektedir. Bu nedenle epizyotomi uygulama kararı alınırken objektif yöntemlerin kullanılması gerekliliği kaçınılmazdır. Araştırmalara göre doku elastikiyetesinin, kas uzayabilirliğinin, perineal vücut uzunluğunun değerlendirilmesi yöntemleri kullanılabilmektedir. Tüm kadınların özellikle üçüncü trimesterde pelvik taban kaslarının viskoelastik özelliklerinin değerlendirilmesi önerilmektedir. Bu şekilde doğum şekli ve önleyici stratejilerin uygulanmasında bireyselleştirilmiş bakım sunulabilecektir. Ayrıca bu değerlendirme sayesinde mediolateral epizyotomi uygulamasına ilişkin nasıl yapıldığı ve doğumdan sonra yapılması gereken bakımlara ilişkin bilgilendirme yapılabileceği belirtilmektedir. Bu tür bir doğum öncesi bilgi, müdahalenin daha iyi kabul edilmesine ve doğum sırasındaki acil durum bilgisine kıyasla gerçek bir bilgilendirilmiş onam alınmasına imkânı sunmaktadır.

Anahtar Kelimeler

• Epizyotomi
• Perine
• Perine yırtıkları

Clinical Evaluation Methods for Limited Episiotomy

Öz

Episiotomy is a surgical incision made in the bulbocavernos muscle in the perineum to facilitate difficult deliveries and widen the birth canal. There is now universal consensus that episiotomy should not be routinely performed. The ACOG states that there is no specific situation in which an episiotomy is necessary, and the decision to episiotomy should be based on clinical judgment. For this reason, it is inevitable to use objective methods when making the decision to perform episiotomy. According to research, methods of evaluating tissue elasticity, muscle extensibility, and perineal body length can be used. It is recommended that all women evaluate the viscoelastic properties of the pelvic floor muscles, especially in the third trimester. In this way, individualized care will be provided in the delivery method and the implementation of preventive strategies. In addition, it is stated that thanks to this evaluation, information can be given about how mediolateral episiotomy is performed and the care that should be done after birth. This type of prenatal information allows for better acceptance of the intervention and real informed consent compared to emergency information at the time of delivery.

Anahtar Kelimeler

• Episiotomy
• perineum
• perineal tears

Kaynakça

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