Incision made into the perineum to enlarge the vaginal outlet and facilitate delivery is called?

JODHPUR AIIMS SNO-2018

Obstetrics and Midwifery Nursing

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

An episiotomy is the correct medical term for a surgically planned incision on the perineum made during the second stage of labor.
The primary purpose of this procedure is to enlarge the vaginal introitus (opening) to facilitate a safe and easy delivery of the fetus.
It is often performed to prevent extensive, uncontrolled perineal tears, to expedite delivery in cases of fetal distress, or to assist in operative vaginal deliveries (e.g., with forceps or vacuum).

Option A: Vaginoplasty is a surgical procedure aimed at constructing or repairing the vagina, often for cosmetic or reconstructive reasons, not to facilitate childbirth.
Option B: A vaginotomy, also known as a colpotomy, is an incision made into the wall of the vagina itself, for purposes such as draining a pelvic abscess. It does not involve the perineum to enlarge the outlet for delivery.
Option D: While 'periniotomy' literally translates to 'incision of the perineum,' it is not the standard or accepted medical term for this obstetrical procedure. 'Episiotomy' is the correct and universally used term.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Surgical procedures related to childbirth as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in post-episiotomy care, focusing on pain relief, infection prevention, and patient education to ensure proper healing and comfort.
Recognizing the indications for an episiotomy, such as fetal distress or shoulder dystocia, is important for the obstetric team to anticipate and prepare for the procedure.
What if? If a patient with a history of a fourth-degree tear (an obstetric anal sphincter injury or OASIS) from a previous delivery becomes pregnant again, the mode of delivery needs careful consideration. While vaginal birth is possible, there is a risk of recurrence. The patient should be counseled on the risks and benefits of a planned cesarean delivery versus a trial of labor to prevent further pelvic floor trauma.

How to Approach the Question

This is a factual recall question that tests your knowledge of obstetrical terminology.
First, break down the question stem to identify the key components: 1) a surgical incision, 2) located on the perineum, 3) for the purpose of enlarging the vaginal outlet during delivery.
Next, evaluate each option based on your knowledge of medical prefixes and suffixes.
'Vagino-' refers to the vagina. 'Plasty' means repair or reconstruction. 'Tomy' means to cut.
'Episio-' refers to the vulva/perineum.
'Perineo-' refers to the perineum.

Concept Tested & Keywords

QSQVlCNZ5NENcmCab1ap9G

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 24-32

E6 Obstetrics Williams p. 15-30