perineal assessment / repair

Question 1

when should perineal inspection take place?

Answer 1

after the delivery of the placenta

Question 2

what are some key aspects for perineal inspection?

Answer 2

• good lighting
  -pain relief for the woman if required
  -check from top to bottom (cervix, vaginal walls, perineum, genitals, anus)
  -always do a PR check
  -use aseptic technique

Question 3

Key aspects for perineal repair

Answer 3

• good lighting
• comfortable position for woman and the midwife
• pain relief for the woman
• lignocaine local anaesthetic
• aseptic technique
• appropriate suturing material for the type of trauma
• a taped tampon to prevent pv loss from obscuring the wound
• carry out repair as soon as possible after the birth to minimise infection and blood loss
  -PR examination post suturing to ensure no sutures have gone into the rectum
  -offer the woman to see it in a mirror and offer care advice

Question 4

what perineal care advice would you give a woman who has had trauma and /or repair

Answer 4

Be aware for signs of infection:
- pain not resolving or worsening
- discharge that is malodorous
- swelling

hygiene - changing pads regularly, showering daily

pain relief - appropriate for breastfeeding if required

ice in the first 2-3 days can help with swelling and improve comfort

healthy balanced diet to enhance tissue repair and minimise constipation