Birth Process Research Articles

Faktor-Faktor yang Berhubungan dengan Kejadian Partus Lama pada Ibu Bersalin di RSUD Djoelham Binjai Tahun 2023

The maternal mortality rate (MMR) in the world based on data from the World Health Organization, according to the World Health Organization (WHO), in 2016 reached 289,000 people, divided into several countries, including the United States reaching 9,300 people, North Africa 179,000 people and Southeast Asia 16,000 soul. Approximately 80% of maternal deaths are the result of increased complications during pregnancy, childbirth and after delivery. Causes of maternal death include postpartum hemorrhage, eclampsia, prolonged labor and sepsis. One of the causes of maternal death is prolonged labor with an average number in the world of 8% and in Indonesia it is 9%. The general aim of this research is to determine the factors associated with the incidence of prolonged labor in women giving birth at the Djoelham Binjai Regional Hospital in 2023. Prolonged labor is a situation where the latent phase occurs for more than 8 hours or labor lasts more than 12 hours with the baby not yet being born. On a partograph, labor that is not progressing is indicated by cervical dilatation above the alert line (right side) in the active phase. The pathophysiology of prolonged labor is closely related to the concept of functional stages of labor which explains the physiological goals of labor. There are three functional stages of labor, namely the preparatory division, the opening/dilatation stage and the pelvic division. This research uses a quantitative type of research using retrospective research. The design of this research was carried out using a cross sectional approach. The sample in the study was women giving birth who experienced a long labor at Djoelham Binjai Regional Hospital in 2023. The proportion of respondents who had a long labor due to a weak vagina < 20' was 12 (40%), respondents who had a long labor due to CPD with In the No CPD category, there were 13 (43.3%) respondents who did not give birth for a long time due to their weight, with the weight category > 4000 grams being 12 (40%). The results (p value = 0.030 < 0.05) which means that this research shows that there is a significant relationship between His, CPD and Baby's Weight with Long Parturition at Djoelham Binjai Regional Hospital. The strength and weakness of the His during the birth process greatly influences the speed or Length of labor It is hoped that respondents will be more active in checking their pregnancies to avoid prolonged labor by health workers either at posyandu or other health service places. Keywords: Partus Lama, Persalinan

The Effect of Warm Compress Hydrotherapy Technique Towards The Intensity of The First Active Stage In Labor Pain For Inpartu Mothers at Herlang Public Health Centre of Bulukumba Regency in 2023

Almost all inpartum mothers experience labor pain, but each mother has a different intensity. Psychology of mothers during childbirth and support from people around during the labor process can affect the intensity of labor pain. When labor pain can not be handled properly, it can make the mother stressed and can hinder the birth process itself.
 This research aimed to know the effect of warm compress hydrotherapy technique towards the intensity of the first active stage in labor pain for inpartum mothers at Herlang Public Health Centre of Bulukumba Regency in 2023.
 This research was a quasi-experimental, namely non-equivalent control group. The sample of this research was inpartu mothers using purposive sampling technique consisting of 30 respondents. Data were analyzed by using univariately in a frequency distribution and bivariate to test the relationship between variables by testing Wilcoxon in the pre - post group and the Mann-Whilney test in the control intervention group.
 The results showed that in the control intervention group using the Mann-Whitney U test was obtained was (0.000 <0.05) and the pre post intervention control group using the Wilcoxon test was obtained value (0.000 0.05).
 The conclusion in this research there is an effect effect of warm compress hydrotherapy technique Towards the intensity of the first active stage in labor pain for inpartum mothers. It is expected to health workers can apply warm compress hydrotherapy techniques to reduce the intensity of labor pain.

PATERNITY LEAVE IN MOTHER AND CHILD WELFARE BILL BASED ON HIFZ AL-NASL PERSPECTIVE AND GOVERNMENT ETHICS POLITICS

The plan of providing 40-day-paternity leave is just waiting for discussion and ratification into law. On the one hand, the RUU KIA (Maternal and Child Health bill (MCH bill) can guarantee the fulfillment of some of mothers’ and children’s rights if they are accompanied by the head of the family during the birth process. However, on the other hand, the status of the husbands who also work for government or private companies requires them to complete the workload, and 40 days of leave is considered a long time for workers to leave. This study aims at examining the implementation of the concept of hifẓ al-nasl on the ethical politics of government concerning the birth of the RUU KIA. This writing is library research by which the data sources were obtained from documents, books, journals, and news on social media. The data were analyzed by using a qualitative approach. The conclusion of this study showed that the philosophical basis of the 40-day-paternity leave policy is a crystallization of the concept of protecting wives and prospective babies and in accordance with the objectives of Islamic law in providing protection for offspring (hifẓ al-nasl). This government’s ethical politics is also an implementation of the rule of taṣarruful imām `alā ra'iyat manūṭun bil maṣlaḥah (policies taken by the government must be ensured to gain benefit for the people).

Experience of Fathers Who Participate During Their Wive's Childbirth: A Phenomenological Study

It is important to know the experience of fathers who provide support during childbirth in terms of improving the childbirth results. This study describes the experiences of fathers who participate during their wives’s childbirth in Türkiye. The research design is qualitative and descriptive, based on a phenomenological approach. Research data were collected through online in-depth interviews between January and February 2021. The sample comprised 12 fathers, reached by criterion sampling. The two data collection tools were the Individual Identification Form and the Semi-Structured Interview Form. Content analysis of the research data was conducted using Maxqda. Four themes emerged to describe the father’s birthing experiences: “prenatal preparation”, “fathers’ birthing support”, “emotions experienced during the birthing”, and “fathers’ views of the birth”. The fathers experienced many contrary emotions during the birth process. Fathers have a positive experience from participating during their partner’s birthing process due to the midwife’s support. Fathers who want to support their partners during birth should be informed about the importance of participating in prenatal courses.

Analysis Of Determinants Of Stunting Incidents In Children Toddler In The Area Of The Bukal District Health Center, Buol District

According to UNICEF, stunting is defined as the percentage of children aged 0-59 months with a height below minus (moderate and severe stunting) and minus three (chronic stunting) measured by WHO child growth standards. Stunting in toddlers manifests chronic nutritional deficiencies both during pregnancy and during the birth process. This research aims to analyze the determinants of stunting in children under five regarding parenting patterns, access to health services, nutritious food, and clean water and sanitation in the Bukal District Health Center Area, Buol Regency. The research was conducted in the Bukal Community Health Center Working Area, Buol Regency. The sample in this study was the entire population of 322 mothers of toddlers in the Bukal District Health Center Area, Buo Regency. This research was an analytical survey research with a cross-sectional design. Based on the findings, it can be concluded that: There is a relationship between parenting pattern factors and the incidence of stunting in children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, ,There is a relationship between the factor of access to health services and the incidence of stunting. In children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, , There is a relationship between the factor of access to nutritious food and the incidence of stunting in children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, There is a relationship between access to clean water and sanitation and the incidence of stunting with a p-value = 0.000. This study concludes that health services are the most related factor, with a significant value of 0.004 and a Wald value of 8.310, meaning that access to health services has a risk of 8,310 times the risk of stunting.

Mmp2 Deficiency Leads to Defective Parturition and High Dystocia Rates in Mice.

Parturition is the final and essential step for mammalian reproduction. While the uterus is quiescent during pregnancy, fundamental changes arise in the myometrial contractility, inducing fetal expulsion. Extracellular matrix (ECM) remodeling is fundamental for these events. The gelatinases subgroup of matrix metalloproteinases (MMPs), MMP2 and MMP9, participate in uterine ECM remodeling throughout pregnancy and parturition. However, their loss-of-function effect is unknown. Here, we determined the result of eliminating Mmp2 and/or Mmp9 on parturition in vivo, using single- and double-knockout (dKO) mice. The dystocia rates were measured in each genotype, and uterine tissue was collected from nulliparous synchronized females at the ages of 2, 4, 9 and 12 months. Very high percentages of dystocia (40-55%) were found in the Mmp2-/- and dKO females, contrary to the Mmp9-/- and wild-type females. The histological analysis of the uterus and cervix revealed that Mmp2-/- tissues undergo marked structural alterations, including highly enlarged myometrial, endometrial and luminal cavity. Increased collagen deposition was also demonstrated, suggesting a mechanism of extensive fibrosis in the Mmp2-/- myometrium, which may result in dystocia. Overall, this study describes a new role for MMP2 in myometrium remodeling during mammalian parturition process, highlighting a novel cause for dystocia due to a loss in MMP2 activity in the uterine tissue.

Peningkatan Pengetahuan Suami Tentang Pendampingan Persalinan Melalui Pemanfaatan E Modul SUMPING (Support Suami Pendamping)

More than 90% of maternal deaths are caused by complications that often occur during or around childbirth. Childbirth complications are a state of deviation from normal, which directly causes morbidity and death of the mother and baby due to disturbances resulting (directly) from childbirth. Reducing the incidence of birth complications requires the participation of the family (especially husbands), which is in line with government policies and strategies in order to reduce the incidence of birth complications in Indonesia through the Making Pregnancy Safer (MPS) program. The expected result of this strategy is to increase the husband's active role during the pregnancy and birth process. Therefore, the community service implementation team (PKM) of the Midwifery Department, Health Polytechnic of the Ministry of Health, Tanjungpinang, carried out PKM activities with the aim of increasing husbands' knowledge about birth assistance through the use of the E Modul SUMPING (Companion Husband Support). The results of this PKM activity were an increase in husbands' knowledge about birth assistance before and after the SUMPING (Companion Husband Support) e-module was socialized.

Проблемы нормы и патологии в социологии здоровья

Currently, the norm is usually understood as a certain average, the most common indicator in society. The concept of norm changed and as a result, different standards of health (ancient, adaptive, anthropocentric) were distinguished in different time pe-riods. In the modern postmodern world, there is an intensive reassessment of norms, individual and social consciousness is changing, the concepts of good and evil, norms and pathology are blurring, where the old norm, which contradicts the new views on success, can be canceled and introduced into the status of pathology.The changes also affected medical practice. So, the reforms of F. Pinel (1793) imbues insanity with a certain medical meaning,the condition or behavior begins to be defined as a medical problem requiring medical intervention. Psychiatry gains professionalpower over the patient, and the psychiatrist gains control over the soul and body of the patient. A psychiatrist, remaining the ultimate truth, de-termines a person's place in the structure of society through diagnosis and stigmatization mechanisms. In addition, new risksare being created in the company. Biomedical technologies regulating the processes of birth, prolongation of human life and death are being de-veloped.

Reducing Maternal Mortality Rate Through Utilization of Agricultural Products and Antenatal Care with Agronursing Perspective

In Indonesia, the number of deliveries assisted by health personnel is still relatively low. Pregnancy checks (Antenatal Care = ANC) can motivate pregnant women to give birth to health workers. This study aims to determine the role of ANC in selecting birth attendants. This cross-sectional study used secondary data from the KKG Project Benefit Evaluation Survey (Family Health and Nutrition)—efforts to Reduce Maternal Mortality Rate Through Utilization of Agricultural Products and Antenatal Care in Agronursing Areas. Maternal Mortality Rate (MMR) is the death of a woman during pregnancy or 42 days after giving birth. Indonesia is a country with a significant increase in the number of maternal mortalities of 359/100,000. This achievement still needs to catch up to the 2024 Millennium Development Goals (MDGs) target, which is 183/100,000 KH, so this has made Indonesia experience a crisis in maternal health services. The low readiness of the mother to fulfill nutritional quality and conduct antenatal care can be a big problem in the birth process. Therefore, it is important to carry out socialization to reduce the maternal mortality rate by utilizing agricultural products to improve maternal nutrition through antenatal care. The purpose of doing community service for pregnant women is to reduce the Maternal Mortality Rate in Indonesia. Community empowerment is carried out by conducting lectures between researchers and participants.

Effectiveness of prenatal yoga on pregnant women's anxiety and duration of labour

The birth process involves physical and psychological mechanisms. Anxiety creates physical and psychological tension, interfering with the birth process. The study aimed to analyze the effectiveness of Yoga on pregnant women's an’iety and labor duration. This study used an experimental design with a Randomized Controlled Trial (RCT) involving 60 pregnant women divided into two groups: Yoga and walking (30 participants each). The variables studied were pregnant women's anxiety and the duration of labor. The sampling technique was conducted using block randomization. Data were analyzed using the Independent T-test. The Yoga group attended 30-minute sessions twice weekly, while the walking group engaged in the same frequency and duration of walking until giving birth. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and one month after the intervention in both groups. The duration of labor was measured using partographs and medical records during delivery for both groups. Data were analyzed using the Shapiro-Wilk test and independent t-test. Pregnant women in both the Yoga and walking groups experienced reduced anxiety scores, with a decrease of 11.6%, and statistically significant p-values of <0.05. The duration of labor was significantly shorter in the Yoga group (mean: 2.65 hours, SD: 1.01) compared to the walking group (mean: 4.01 hours, SD: 2.54), with a mean difference of 1.36 hours and a p-value of <0.05. Prenatal Yoga in the third trimester reduces pregnant women's an’iety and shortens the duration of labor. It can be suggested as an alternative exercise for pregnant women to improve maternal health during pregnancy and childbirth.

HUBUNGAN TINGKAT PENGETAHUAN DAN DUKUNGAN KELUARGA TERHADAP PENURUNAN RASA NYERI PERSALINAN DI KLINIK RAWAT INAP NU MADINAH PUJON KABUPATEN MALANG

Pain during labor is a concrete condition that threatens the birth mother, causing feelings of tension, worry and fear. For this reason, pregnant women try to be successful in dealing with this situation as best as possible until the time of delivery arrives, so support from their husband and family is really needed during the birth process, so that the mother feels safe and comfortable during the birth process. The sampling method was a total sampling of 30 pregnant women who experienced pain during childbirth. The data analysis method used is simple linear regression analysis. Based on the results of research at the NU Madinah Pujon inpatient clinic, there is a calculated T value for the family support variable (X2) of 6.986 > T table 2.048, meaning there is a significant relationship between family support (X2) and a decrease in labor pain (Y). The conclusion in this case is that family support will bring a feeling of joy, a sense of security, a sense of satisfaction and a sense of comfort, which will make the mother in labor feel that she is getting emotional support which will affect her mental well-being, and can relax when the mother feels pain.

Insights into the adaptive evolution of chromosome and essential traits through chromosome-level genome assembly of Gekko japonicus

Gekko japonicus possesses flexible climbing and detoxification abilities under insectivorous habits. Still, the evolutionary mechanisms behind these traits remain unclarified. This study presents a chromosome-level G.japonicus genome, revealing that its evolutionary breakpoint regions were enriched with specific repetitive elements and defense response genes. Gene families unique to G.japonicus and positively selected genes are mainly enriched in immune, sensory, and nervous pathways. Expansion of bitter taste receptor type 2 primarily in insectivorous species could be associated with toxin clearance. Detox cytochrome P450 in G. japonicus has undergone more birth and death processes than biosynthesis-type P450 genes. Proline, cysteine, glycine, and serine in corneous beta proteins of G.japonicus might influence flexibility and setae adhesiveness. Certain thermosensitive transient receptor potential channels under relaxed purifying selection or positive selection in G. japonicus might enhance adaptation to climate change. This genome assembly offers insights into the adaptive evolution of gekkotans.

Association of maternal SARS-CoV-2 infection at the time of admission for delivery with labor process and outcomes of vaginal birth: A cohort study.

This study aimed to investigate the impact of maternal SARS-CoV-2 infection at the time of admission for delivery on labor process and outcomes of vaginal birth. A cohort study was carried out at the Obstetrics Department of Anhui Provincial Hospital, China, where universal reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 infection was introduced for all women admitted for labor and delivery from December 1-31, 2022. Women were divided into positive and negative groups based on the test result. All women having a singleton vaginal birth were included in final analysis. The effect of SARS-CoV-2 positivity on labor process and outcomes of vaginal birth was estimated by regression analyses. Among a total of 360 women included, 87 had a positive SARS-CoV-2 test and 273 a negative test. Women in the positive group had an increased likelihood of having longer labor (median 9.3 vs 8.3 hours; sB [log-transformed] 0.19; 95% confidence interval [CI] 0.09-0.28), episiotomy (39.1% vs 23.8%; adjusted odds ratio [aOR] 2.31; 95% CI 1.27-4.21), grade III meconium-stained amniotic fluid (19.5% vs 7.0%; aOR 2.52; 95% CI 1.15-5.54) and postpartum hospital stay exceeding 37 hours (58.6% vs 46.5%; aOR 1.71; 95% CI 1.00-2.91). They had reduced rates exclusive breastfeeding (26.7% vs 39%; aOR 0.21; 95% CI 0.09-0.46) as well as mixed feeding (46.5% vs 52.2%; aOR 0.28; 95% CI 0.13-0.60) at 1 week postpartum. No significant differences were observed in other aspects of labor process and birth outcomes, including the uptake of labor analgesia, postpartum hemorrhage (>500 mL) or neonatal outcomes. A positive maternal SARS-CoV-2 test in labor among women having vaginal birth was associated with a slightly longer duration of labor, increased likelihood of episiotomy, increased incidence of grade III meconium-stained amniotic fluid, a longer postpartum hospital stay and a lower rate of breastfeeding 1 week postpartum. However, it did not have an adverse impact on other birth outcomes.

UPAYA PENINGKATAN KESEHATAN IBU HAMIL MELALUI EDUKASI MENGGUNAKAN LEMBAR BALIK KEPADA KADER DAN IBU HAMIL

The World Health Organization (WHO) estimates that 830 women in the world and in Indonesia 38 mothers die every day due to complications from pregnancy and the birth process (WHO, 2019). K1 and K4 visits in the working area of the Karang Intan 2 Community Health Center, Banjar Regency from January to May 2022 were not optimal, it was found that the K1 visit coverage of 38.79% and K4 34.35% was still less than the expected K1 and K4 achievement percentage. The programs at posyandu are also not much developed due to the limitations and lack of knowledge of cadres. Efforts to carry out training of cadres in efforts to improve the health of pregnant women through education using feedback sheets for cadres and pregnant women in the working area of Karang Intan 2 Health Center, Banjar Regency. This service aims to increase the knowledge and understanding of cadres and pregnant women regarding how to improve the health status of pregnant women in the Karang Intan 2 Health Center Working Area, Banjar Regency. The method involves training and mentoring for cadres using Power Point media, videos, flip sheets and leaflets. Participants consist of 20 cadres from PKM Partners, 10 pregnant women, 1 midwife and 1 nutritionist at Karang Intan 2 Community Health Center, Banjar Regency, evaluated through pre-test and post-test as well as monitoring and evaluation by assessing cadre counseling for pregnant women at the posyandu. The results show that there is an increase in improvement from before, this shows that the material presented can be understood by cadres and pregnant women well

Mechanism Underlying the Regulation of Mucin Secretion in the Uterus during Pregnancy

The function of endometrial epithelial cells is to secrete various substances that are rich in growth factors and nutrients. These substances support both embryo implantation and its subsequent development into a fetus. A vast number of mucins are expressed in endometrial epithelial cells, and they play an important role in regulating the processes of embryo implantation, pregnancy, and parturition. Previous studies have shown that mucin forms a mucus layer covering endometrial epithelial cells, which helps resist damage from foreign bacteria and their toxins. Therefore, this article aims to investigate the location of mucins in the endometrium, the mechanism of mucin secretion by the endometrium, and the regulation of mucins in the uterine epithelium by reproductive hormones, as well as the role of mucins in the protection of the epithelium’s structure. This research aims to provide a foundational understanding for future studies on the role and mechanism of endometrial mucins throughout the pregnancy cycle.

Time-Inhomogeneous Finite Birth Processes with Applications in Epidemic Models

We consider the evolution of a finite population constituted by susceptible and infectious individuals and compare several time-inhomogeneous deterministic models with their stochastic counterpart based on finite birth processes. For these processes, we determine the explicit expressions of the transition probabilities and of the first-passage time densities. For time-homogeneous finite birth processes, the behavior of the mean and the variance of the first-passage time density is also analyzed. Moreover, the approximate duration until the entire population is infected is obtained for a large population size.

Edukasi dan Pendampingan Ibu Bersalin Kala 1 dalam Melakukan Mobilisasi di Ruang Bersalin Puskesmas Paiton

Childbirth is the birth of the baby, placenta and amniotic membranes from the uterus to the outside world. Long labor causes mothers to experience stress and fatigue for longer so that pain will increase. The causes of labor pain are caused by various factors such as uterine muscle contractions, stretching of the pelvic floor muscles, episotomy and psychological conditions, namely anxiety which can increase the incidence of stress. To overcome prolonged labor, active labor techniques have been introduced. The active labor method has actually been implemented as one of the care services during the birth process, namely in terms of mobilization which encourages the mother to choose the position that is considered the most comfortable with the aim of minimizing pain and which can affect the length of labor. labor. first and second stages of labor. In reality, there are still many mothers who give birth who experience difficulty in mobilizing and positioning and only focus on the pain and are afraid to move so they only stay in one position during the birth process, this can make the muscles stiff and cause pain. it is difficult for the fetus to descend into the pelvis. Based on research, pregnant women who carry out mobilizations such as walking lightly and arranging a comfortable position can speed up the descent of the head and the opening of the cervix. This service takes the form of providing education about the benefits of mobilization for mothers during the first stage of labor and providing assistance with mobilization in the delivery room. Providing education and assistance can help mothers in labor empower themselves in undergoing labor so that it is hoped that labor can run smoothly. This community service can help mothers in labor to empower themselves to mobilize in an effort to speed up the descent of the fetal head, speed up opening and the mother can adjust to a comfortable position so that the birth runs smoothly.

Evaluasi Pemberian Makanan Tambahan pada Ibu Hamil dengan Kekurangan Energi Kronis (KEK) dari Program Corporate Social Responsibility (CSR) di Wilayah Kerja Puskesmas Tegal Angus Kabupaten Tangerang Tahun 2022

The condition of pregnant women who are at risk of CED can cause a decrease in the ability of the muscles that support the birth process. This can cause prolonged labor as well as bleeding, which is dangerous for the mother. Based on this, PT. Agung Sedayu Group pays special attention to the condition of chronic energy deficiency in pregnant women by creating a supplementary food program in the form of a unique and complete menu in the hope of helping to reduce the prevalence of chronic energy deficiency in pregnant women. The aim of this research is to find out how to evaluate the provision of additional food to pregnant women with chronic energy deficiency (KEK) from the Corporate Social Responsibility (CSR) program in the Tegal Angus Community Health Center work area in 2022. This type of research applies the Mixed Methods method with a Sequential Explanatory design The design starting from the first step of the research was carried out using quantitative methods and the second step was carried out using qualitative methods. Secondary data collection techniques were taken from Community Health Center data, while primary data were collected using in-depth interviews. Data analysis was carried out using the Wilxocon test. The research results showed that there were differences in the nutritional status of KEK pregnant women seen from LiLA with a significance value of 0.000 (p

Pengaruh Pemberian Kompres Hangat Terhadap Nyeri Persalinan Pada Inpartu Kala I Fase Aktif Di RSI Fatimah Banyuwangi Tahun 2022

Labor is the process by which the fetus and amniotic fluid are pushed out through the birth canal. During the birth process the mother will experience pain. Pain that is uncontrolled or excerssive and does not get proper treatment can cause problems with difficulty in childbirth. A non-pharmocological method that is quite safe was to determine the effect of giving warm compresses to labor pain in the active phase of the first stage of labor at Fatimah Banyuwangi Hospital in 2022. The research method used a pre-exsperimental one group pretest posttest on 30 respondents who met the inclusion criteria, namely pregnant women in the first active phase, singleton pregnancies, head presentations, term pregnancies, normal delivery plants, fetal interpretation between 2500-4000 grams, accompanied by their husbands or family. Data collection was carried out using the VAS observation sheet and warm compress SOP. Then the data is processed through the process of editing, coding,scring, tabulating and statistical analysis of the Wilcoxon test. The result showed that the level of labor pain before the intervention was mostly in the severe pain category by 53% and after the warm compress intervention there was a decrease in the pain level, namely in the moderate pain category by 70%. Wilcoxon test reslts Asymp. Sig. (2-tailed) 0,00 < 0,05 means that there is a significant effect of giving warm compresses to labor pain in the active phase I parturition at RSI Fatimah Banyuwangi in 2022. Proper application of warm compresses according to the procedure gives a feeling of warmth and causes vasoconstriction so that labor pain in the first stage can be reduced. This method is safe and can be an alternative choice for midwives in the management of pain care during labor.

Clinical and Aesthetic Review of Episiotomy Wound Closure Methods.

An episiotomy is a surgical incision in the perineum to facilitate the baby's head during delivery. Physicians or midwives may use this procedure if he/she finds out the tissue around the vaginal opening begins tearing or does not seem to be stretching enough to allow the baby to be delivered. With an increasing trend for hospital births and for physicians to get involved in the normal uncomplicated birth process, there was rise in the number of episiotomies. After the baby is delivered through the extended vaginal opening, the area is applied with local anesthetic agent and incision is repaired with sutures. Our study reviewed the development in the past twenty years regarding episiotomy wound closure methods, and discovered that continuous sutures for episiotomy or perineal repair have clinical advantages in term of faster and better wound healing, more favorable scarring, shorter post-procedural pain, more rapid resumption of sexual activity, lower incidence of urinary incontinence, compared to interrupted sutures. They were also beneficial in term of less consumption of suture materials. In determining suture materials, clinicians should strongly consider the tear severity, tissue characteristics, as well as the desired aesthetic outcome.