Spontaneous episiotomy dehiscence

Cut in the perineum made by the gynaecologist or midwife during labour when conditions require it, to prevent vaginal tears and to reduce the length of the expulsion period of the foetus. Once the baby is expelled, the edges of the incision are sutured to close the episiotomy.

Episiotomy dehiscence is when the edges of the incision separate due to suture failure; it can be classified as partial or complete dehiscence depending on the degree of wound opening.

It is usually caused by wound infection, although there are other causes that hinder proper healing of the suture: obesity, diabetes mellitus, poor nutrition, smoking, haematoma and/or inflammation of the scar.

Diagnosis is clinical by direct observation of the open wound, although it may be necessary to carry out a blood test to assess the existence of infection.

In most cases it is decided to wait for the scar to close spontaneously, although this is a slow process that can take several weeks. When the tear is complete it may be necessary to repair it with a second surgery. If there are signs of infection, antibiotic treatment will also be added.