Episiotomy

**Episiotomy nke amara dika perineotomy, bu surgical incision nke perineum na posterior vaginal wall nke obstetrician na eme. Ana eme ya n'oge abuo nwaanyi na Acho imu NWA eji mmepe aperture, eji kwe Ka NWA ahu gafee.** 

A naghịzi atụ aro iji ya eme ihe mgbe niile, dị ka ịhịa aka perineal, ụdị ụkpụrụ nke onye dọkịta na-awa ahụ plastik nke 'mgbasawanye anụ ahụ' nke a na-etinye n'oghere akụkụ ahụ nwanyị, bụ ụzọ ọzọ na-enweghị ihe mgbu iji gbasaa oghere maka nwa ahụ.   N'agbanyeghị nke ahụ, ọ bụ otu n'ime usoro ịwa ahụ a na-ahụkarị maka ụmụ nwanyị. Na United States, ka ọ na-erule afọ 2012, a na-eme ya na 12% nke ọmụmụ nwa. [1] A ka na-eme ya n'ọtụtụ akụkụ nke ụwa, gụnyere Korea, Japan, Taiwan, China, na Spain.  

## Ojiji
Anya mmiri nke akụkụ ahụ nwanyị nwere ike ịpụta n'oge ịmụ nwa, ọtụtụ mgbe na introitus ka isi nwa ahụ na-agafe, karịsịa ma ọ bụrụ na nwa ahụ agbadata ngwa ngwa. A na-eji episiotomies eme ihe na mgbalị iji gbochie ịdọwa ahụ dị nro (ịdọwa perineal) nke nwere ike ịgụnye sphincter anal na rectum. Anya mmiri nwere ike ịgụnye akpụkpọ ahụ perineal ma ọ bụ gbasaa na uru ahụ na sphincter anal na anus. Onye na-amụ nwa ma ọ bụ onye na-ahụ maka ịmụ nwa nwere ike ikpebi ịwa ahụ na perineum na mma ma ọ bụ scalpel iji mee ka ọmụmụ nwa ahụ dịkwuo mfe ma gbochie nnukwu mmerụ ahụ nke nwere ike isi ike idozi. A na-edozi ọkpụkpụ ahụ site na sutures. Ụfọdụ ụlọ ọrụ ịmụ nwa nwere iwu nke episiotomy.

Ihe ndị doro anya mere e ji mee episiotomy edoghị anya. Ọ bụ ezie na ihe ngosi banyere mkpa episiotomy dịgasị iche ma nwee ike ịbụ arụmụka (lee mkparịta ụka n'okpuru), ebe a na-etinye usoro ahụ, enwere ọdịiche abụọ. A na-egosi ha abụọ na foto dị n'elu.

* N'otu ọdịiche, episiotomy nke etiti, akara nke incision dị n'etiti anus. Usoro a na-ekewa perineal ahụ, nke dị mkpa maka iguzosi ike n'ezi ihe nke ala pelvic. Ịmụ nwa ngwa ngwa nwekwara ike belata - ma sie ike karị - ahụ perineal, na-eduga na nsogbu ogologo oge dị ka incontinence. Ya mere, a na-ejikarị usoro oblique eme ihe (nke e sere n'elu).
* Na usoro oblique, a na-ezere ahụ perineal, na-ebipụ naanị epithelium, akpụkpọ ahụ, na uru ahụ (transversalius na bulbospongiosus). Usoro a na-enyere aka izere mmerụ ahụ na perineal site na ịwa ahụ ma ọ bụ ụzọ traumatic.

N'afọ 2009, nyocha Cochrane meta-analysis dabere na ọmụmụ ihe ndị nwere ihe karịrị ụmụ nwanyị 5,000 kwubiri na: "Ụkpụrụ episiotomy na-egbochi yiri ka ọ nwere ọtụtụ uru ma e jiri ya tụnyere iwu ndị dabeere na episiotomia. Enwere obere mmerụ ahụ perineal, obere suture na obere nsogbu, ọ nweghị ọdịiche maka ọtụtụ ihe mgbu na nnukwu mmerụ ahụ n'ahụ ma ọ bụ perineal. "  Ndị dere ya enweghị ike ịchọta nyocha dị mma nke jiri mediolateral tụnyere midline episiotomy.[1]

## Ụdị
E nwere ụdị anọ bụ isi nke episiotomy: 

* Medio-lateral: A na-eme oghere ahụ ala na mpụga site n'etiti etiti nke fourchette ma ọ bụ n'aka nri ma ọ bụ aka ekpe. A na-eduzi ya n'ụzọ kwụ ọtọ nke na-agba ihe dị ka 2.5 cm (1 in)  na anus (etiti etiti n'etiti anus na ischial tuberosity).
* Median: Ọkpụkpụ ahụ na-amalite site n'etiti nke fourchette ma gbasaa n'akụkụ azụ n'etiti etiti maka 2.5 cm (1 in).
* N'akụkụ: Ọkpụkpụ ahụ na-amalite site na ihe dị ka 1  in) site n'e nke fourchette ma gbasaa n'akụkụ. Ihe mgbochi gụnyere ohere nke mmerụ ahụ na ọwara Bartholin, ya mere ụfọdụ ndị na-arụ ọrụ agbaala nkwụsịtụ n'akụkụ.
* Ụdị *J*: Ọkpụkpụ ahụ na-amalite n'etiti etiti nke fourchette ma na-eduzi ya n'azụ n'etiti ihe dị ka 1.5 sentimita (0.59 in) wee gaa n'ala na n'èzí n'akụkụ 5 ma ọ bụ 7 elekere iji zere sphincter n'ime na nke dị n"èzí. A naghị emekarị usoro a n'ọtụtụ ebe.