a dam cut (medical Episiotomie) is cutting the dam of the woman with the birth, in order to facilitate a difficult birth procedure, for example in case of a steissgeburt. In many places usual „preventive “dam cut is to forestall a possible dam tear.
An experienced birth aid (for example a midwife) can possibly prevent a tearing by special grasp techniques. It is maintained by the water birth that it the frequency of the dam cuts or - reduces injuries clearly.
The cut takes place usually during presssore with special Episiotomie shears (with a pointed and a blunt thigh) without beta exercise. The sewing of the wound takes place only some time after the birth under local beta exercise.
Fundamentally there are three kinds of the dam cut:
- With the medianen Episiotomie is cut along the center line. The cut is quite short and has in relation to the other variants the best healing prospects. It can occur however that during a further overstretching the cut further-tears to the after, which can lead to complications.
- With the mediolateralen Episiotomie the cut is made on the basis of the center in the 45°-Winkel and can be led because of the missing delimitation by the after longer, which leads to a higher space gain.
- The lateral Episiotomie is implemented in the 45°-Winkel, however about 2 cm by the center is shifted. Because of the every now and then bad healing these generally no more one does not accomplish.
pro and cons
a dam cut can be compellingly necessary, in order to facilitate a difficult birth procedure, for example in case of a steissgeburt.
From view this method mainly used with births in the clinical surrounding field makes an easier sewing for past practice possible by the straight cut, than it is with tears the case, which could develop in the process of the birth.
However sometimes a preventive dam cut is questioned. A preventive interference has usually only small use and nachgeburtliche impairments in the separating and after range is possible.
According to a study (see literature) there are no proving that a by routine accomplished dam cut can reduce the frequency of complaints after the birth („Evidence of does emergency support maternal benefits traditionally ascribed tons of routine episiotomy."). On the other hand to the disadvantage it is referred that with not accomplished Episiotomie if necessary. at all no birth injuries would have arisen. („In fact, outcomes with episiotomy CAN considered worse sinks some proportion OF women who would have had more lesser injury instead had A surgical incision.").
To consider is if necessary. also that a natural wound heals generally better than an artificially caused (cut).
Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN: Outcomes OF routine episiotomy: A systematics review. JAMA. 2005 May 4; 293 (17): 2141-8. PMID 15870418
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