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Perineal Tear
A perineal tear is a laceration of the skin and other soft tissue structures which, in women, separate the vagina from the anus. Perineal tears mainly occur in women as a result of vaginal childbirth, which strains the perineum. It is the most common form of Obstetric labor complication, obstetric injury. Tears vary widely in severity. The majority are superficial and may require no treatment, but severe tears can cause significant bleeding, long-term pain or dysfunction. A perineal tear is distinct from an episiotomy, in which the perineum is intentionally incised to facilitate delivery. Episiotomy, a very rapid birth, or large fetal size can lead to more severe tears which may require surgical intervention. Anatomy In women, an anatomical area known as the perineum separates the opening of the vagina from that of the anus. Each opening is surrounded by a wall, and the anal wall is separated from the vaginal wall by a mass of soft tissue including: * The muscles of the anus (corr ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hem ...
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Pubococcygeus
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the lesser pelvis, and these unite to form the greater part of the pelvic floor. The coccygeus muscle completes the pelvic floor, which is also called the ''pelvic diaphragm''. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and contracts rhythmically during female orgasm, and painfully during vaginismus. Structure The levator ani is made up of 3 parts: * Iliococcygeus muscle * Pubococcygeus muscle * Puborectalis muscle The iliococcygeus arises from the inner side of the ischium (the lower and back part of the hip bone) and from the posterior part of the tendinous arch of the obturator fascia, and is attached to the coccyx and anoco ...
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Water Birth
Water birth is childbirth that occurs in water, usually a birthing pool. It may include the use of water for relaxation and pain relief during the first stage of labour, birth into water in the second stage of labour, and the delivery of the placenta in the third stage of labour. Benefits Proponents believe childbirth in water results in a more relaxed, less painful experience. A 2018 Cochrane Review of water immersion in the first stages of labour found evidence of fewer epidurals and few adverse effects but insufficient information regarding giving birth in water. A moderate to weak level of evidence indicates that water immersion during the first stage of childbirth reduces the pain of labour. A 2018 Cochrane Review found that immersion at this stage reduces the use of epidural analgesia; however, there is no clear evidence on the benefits of immersion for the second stage of labour, namely delivery (sometimes called full water birth). There is no evidence of increas ...
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Cochrane (organisation)
Cochrane is a British international charitable organisation formed to synthesize medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes 53 review groups that are based at research institutions worldwide. Cochrane has over volunteer experts from around the world. The group conducts systematic reviews of healthcare interventions and diagnostic tests and publishes them in the Cochrane Library. While Cochrane reviews typically focus on randomized controlled trials, some reviews, particularly in areas such as public and occupational health, also incorporate other study designs. These may include non-randomised observational studies as well as controlled before–after (CBA) studies and interrupted time-series studies. According to the Library, articles are available via one-click access, though some may require registration or a subscription. History Cochrane, prev ...
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Human Anus
In humans, the anus (: anuses or ani; from Latin ''ānus'', "ring", "circle") is the external opening of the rectum located inside the intergluteal cleft. Two sphincters control the exit of Human feces, feces from the body during an act of defecation, which is the primary function of the anus. These are the internal anal sphincter and the external anal sphincter, which are circular muscles that normally maintain constriction of the orifice and which relax as required by normal physiological functioning. The inner sphincter is involuntary and the outer is voluntary. Above the anus is the perineum, which is also located beneath the vulva or scrotum. In part owing to its exposure to feces, a number of medical conditions may affect the anus, such as hemorrhoids. The anus is the site of potential infections and other conditions, including cancer (see anal cancer). With anal sex, the anus can play a role in Human sexuality, sexuality. Attitudes toward anal sex vary, and it is illeg ...
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Fascia
A fascia (; : fasciae or fascias; adjective fascial; ) is a generic term for macroscopic membranous bodily structures. Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location. The knowledge of fascial structures is essential in surgery, as they create borders for infectious processes (for example Psoas abscess) and haematoma. An increase in pressure may result in a compartment syndrome, where a prompt fasciotomy may be necessary. For this reason, profound descriptions of fascial structures are available in anatomical literature from the 19th century. Function Fasciae were traditionally thought of as passive structures that transmit mechanical tension generated by muscular activities or external forces throughout the body. An important function of muscle fasciae is to reduce friction of muscular force. In doing so, fasciae provide a supportive and movable wrapping for nerves and blood vessels as they pass thro ...
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Mucosa
A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is mostly of endodermal origin and is continuous with the skin at body openings such as the eyes, eyelids, ears, inside the nose, inside the mouth, lips, the genital areas, the urethral opening and the anus. Some mucous membranes secrete mucus, a thick protective fluid. The function of the membrane is to stop pathogens and dirt from entering the body and to prevent bodily tissues from becoming dehydrated. Structure The mucosa is composed of one or more layers of epithelial cells that secrete mucus, and an underlying lamina propria of loose connective tissue. The type of cells and type of mucus secreted vary from organ to organ and each can differ along a given tract. Mucous membranes line the digestive, respiratory and rep ...
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Frenulum Labiorum Pudendi
The frenulum of labia minora (fourchette or posterior commissure of the labia minora) is a frenulum where the labia minora meet posteriorly. Pathology The fourchette may be torn during delivery due to the sudden stretching of the vulval orifice, or during copulation. To prevent this tearing in a haphazard manner, obstetricians and, less frequently, midwives may perform an episiotomy, which is a deliberate cut made in the perineum starting from the fourchette and continuing back along the perineum toward the anus. Sometimes this surgical cut may extend to involve the perineal body and thus reduce anal sphincter function. Thus some obstetricians have opted to perform a posterior-lateral cut in the perineum to prevent this potential complication from occurring. The fourchette may also be torn in acts of violence wherein forced entry occurs such as rape. When the fourchette is torn, the bleeding which ensues sometimes requires surgical suturing for containment. Etymology The fourch ...
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Subcutaneous Tissue
The subcutaneous tissue (), also called the hypodermis, hypoderm (), subcutis, or superficial fascia, is the lowermost layer of the integumentary system in vertebrates. The types of cells found in the layer are fibroblasts, adipose cells, and macrophages. The subcutaneous tissue is derived from the mesoderm, but unlike the dermis, it is not derived from the mesoderm's Dermatome (anatomy), dermatome region. It consists primarily of loose connective tissue and contains larger blood vessels and nerves than those found in the dermis. It is a major site of fat storage in the body. In arthropods, a hypodermis can refer to an epidermal layer of cells that secretes the chitinous cuticle. The term also refers to a layer of cells lying immediately below the Epidermis (botany), epidermis of plants. Structure * Fibrous bands anchoring the skin to the deep fascia * Collagen and elastin fibers attaching it to the dermis * Fat is absent from the eyelids, clitoris, penis, much of Pinna (anatomy ...
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Human Skin
The human skin is the outer covering of the body and is the largest organ of the integumentary system. The skin has up to seven layers of ectodermal tissue (biology), tissue guarding Skeletal muscle, muscles, bones, ligaments and organ (anatomy), internal organs. Human skin is similar to most of the other mammals' skin, and it is very similar to pig skin. Though nearly all human skin is covered with hair follicles, it can appear Nudity#Evolution of hairlessness, hairless. There are two general types of skin: hairy and glabrous skin (hairless). The adjective List of medical roots, suffixes and prefixes#C, ''cutaneous'' literally means "of the skin" (from Latin ''cutis'', skin). Skin plays an important immunity (medical), immunity role in protecting the body against pathogens and excessive transepidermal water loss, water loss. Its other functions are Thermal insulation, insulation, thermoregulation, temperature regulation, sensation, synthesis of vitamin D, and the protection ...
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Fascia Of Perineum
The fascia of perineum (deep perineal fascia, superficial investing fascia of perineum or Gallaudet fascia) is the fascia which covers the muscles of the superficial perineal pouch. The muscles surrounded by the deep perineal fascia are the bulbospongiosus, ischiocavernosus, and superficial transverse perineal. The fascia is attached laterally to the ischiopubic rami and fused anteriorly with the suspensory ligament of the penis or clitoris. It is continuous anteriorly with the deep investing fascia of the abdominal wall muscles, and in males, it is continuous with Buck's fascia Buck's fascia (deep fascia of the penis, Gallaudet's fascia or fascia of the penis) is a layer of deep fascia covering the three erectile bodies of the penis. Structure Buck's fascia is continuous with the external spermatic fascia in the scro .... {{Authority control Fascia ...
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