GynaePulse
Join the launch
Minor & bedside proceduresFree in the app

Episiotomy & 2nd-degree repair

Fetal compromise, instrumental birth, or to prevent a severe tear.

Source: NICE NG235 · RCOG GTG 29

Episiotomy

  1. Infiltrate 1% lidocaine.
  2. Mediolateral cut from the fourchette, 60° from midline, with perineum stretched.

Repair

  1. Good light, lithotomy; rectal exam to exclude OASI; count.
  2. Vaginal layer: anchor above apex; continuous non-locking 2-0 to the hymen.
  3. Perineal muscle: interrupted or continuous.
  4. Skin: continuous subcuticular.
  5. Rectal exam and count; NSAID analgesia.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.