Pós-parto sem Dor: Reparo Correto e Cuidados Após Lacerações | Inspiracast #13

Discover the Postgraduate Program in Urogynecology at Inspirali Postgraduate Medicine! https://inspiraliposmedicina.com/curs... Dive into the podcast of the Postgraduate Program in Urogynecology and understand, with host Dr. Karine Rhein Gavioli Michelleti and guest Dr. Paulo Chinen (EPM/Unifesp; Master's and PhD; coordinator of the Gynecology and Obstetrics postgraduate program at Inspirali), how to prevent, identify, and repair perineal lacerations during childbirth. The episode covers classification by degrees, effective prevention measures during prenatal care and labor, current indications for episiotomy, postoperative care, and the functional and psychosocial impact of injuries when not treated adequately. At the end, the instructors reinforce the importance of practical training and invite you to the postgraduate course on laceration and late perineal rupture repair. What you will learn in this episode: ✅ Frequency and classification of lacerations (grades 1 to 4): what is common, what is serious, and why proper classification is important [1:23 - 2:28] ✅ Anatomical recognition and immediate repair: why identifying structures and correcting them during labor improves outcomes [2:28 - 3:44] ✅ Sequelae of inadequate approach: sexual dysfunction, chronic pain, urinary/fecal incontinence, and social/psychological impact [3:44 - 4:45] ✅ Prevention in prenatal care: pelvic physiotherapy and perineal massage with natural oils when physiotherapy is not accessible [4:45 - 5:29] ✅ Intrapartum strategies that work: warm compresses during the expulsive phase, slow delivery of the fetal head (cephalic pole), and active protection of the perineum (head and posterior shoulder) [5:35 - 6:48] ✅ Fears that influence the mode of delivery: how qualified information in prenatal care reduces cesarean sections due to fear of "dropped bladder"/lacerations [6:55 - 8:18] ✅ Post-operative care by degree: analgesia, ice, laxative diet, caution with constipating analgesics and sexual return after reassessment (≈40–45 days) [8:19 - 9:59] ✅ Episiotomy today: not routine; when to have it "up your sleeve" (short perineum, macrosomia, prolonged expulsion, forceps-assisted deliveries); anatomical alternative with midline perinotomy; The decision is made during the expulsive phase [9:59 - 13:28] ✅ How to talk to the patient: trust, continuous alignment (birth plan built during prenatal care), and assurance of adequate repair, if necessary [14:26 - 15:50] ✅ Message to doctors: study anatomy, use appropriate material (absorbable suture), careful hemostasis, avoid hematomas/infection, and above all, do not rush the repair [15:59 - 17:08] ✅ Postgraduate bonus: practical class on repairing postpartum lacerations and late perineal rupture to consolidate technique and decision-making [17:55 - 18:10] About the participants: Dr. Karine Rhein Gavioli Michelleti: physician, host of the Urogynecology Postgraduate podcast at Inspirali Postgraduate Medicine. Dr. Paulo Chinen: Obstetrician with extensive experience, graduated from the Paulista School of Medicine (EPM/Unifesp), Master's and PhD; coordinator of the postgraduate program in Gynecology and Obstetrics at Inspirali Postgraduate Medicine. 🔔 Subscribe to the channel for more podcasts about medical careers and postgraduate studies. 📲 Follow our social media for news on medical training. #Urogynecology #Obstetrics #PostgraduateMedicine #Inspirali #NormalDelivery #Perineum #Episiotomy #PelvicPhysiotherapy #Women'sHealth #CareersInMedicine