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Flashcards in Instrumental Delivery Deck (10)
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1
Q

Indications of Forceps?

A

Delay in 2nd stage of labour - poor maternal effort or exhaustiin.

Maternal Indications
Cardiac and Resp Disease
Uncontrolled BP
Previous C- section

Fetal Indications
Fetal distress
Aftercoming head of breech

2
Q

Types of Obstetric Forceps

A

Long shaft - neville barnes
Short shaft - wrigley, not generally used, useful for delivering head at C/S
Rotational Forceps - keillands, not used, fetal and pelvic trauma

3
Q

Prerequisites of Forceps Delivery?

A
  • vertex delivery or aftercoming head of breech
  • less then 1/5 head above brim, no CPD
  • pelvis must be adequate size
  • cervix fully dilated
  • membranes ruptured
  • empty bladder
  • adequate uterine contractions
  • episiotomy
  • saggital suture in AP
  • afequate analgesia
4
Q

Preparation for Forceps Delivery?

A
  • analgesia
  • lithotomy position
  • selection of instrument
  • episiotomy
  • left blade applied first
  • traction - only during contractions
5
Q

Complication of Forceps Delivery?

A

Maternal

  • lacerations vagina cervix uterus
  • pph due to tears or uterine atony
  • puerperal infection
  • trauma to bladder or rectum
  • long term -pelvic organ prolapse/incontinence

Fetal

  • death
  • skull fracture
  • intracranial hge
  • facial nerve palsy
  • lacerations
  • brachial plexus injury
6
Q

Indications for a Vacuum extractor?

A

Same as forceps but can be used when saggital suture is not in the AP position.

7
Q

Contraindications of Ventouse?

A

-prem

8
Q

Dis/Advantages of Ventous

A
  • facikitaes flexion of head
  • allows rotation without trauma
  • occupies no extra space therefore episiotomy not needed
  • less maternal trauma

Disadv
Higher risk of fetal injury
Delivery takes longer than with forceps

9
Q

Complications of Ventouse?

A
Fetal 
- abrasions lacerations on scalp
-chignon (arificial caput succedaneum
-cephalohaematoma -hg under periosteum
Intracranial hge
-anaemia and jaundice

Maternal
As for forceps but lesser extent

10
Q

What are the use of Forceps?

A

Expedite delivery in second stage of labour.
After coming head of breech.
Delivery of head at c-section.