8. Management of shoulder dystocia types :-
1. Foreceps delivery :- Foreceps delivery means using
obstertic foreceps for delivery when the mother is unable
to deliver the baby by her own efforts.
Foreceps delivery is an assisted birth with the aid of forecep.
These are designed to crudle the baby head as traction on
handles assist baby to be turned.
Purpose :-
To assist in delivery after coming head breech.
To take out head up and out of pelvis at cesarean section
To rotate and take out the head in an unfavourable positions
of baby in vertex presentation.
To deliver baby quickly in case of fetal distress after fulfilling
the conditions for use forceps.
9. Indications for use of forceps :-
Maternal
Fetal
Miscellaneous/Others
MATERNAL INDICATIONS
Maternal heart disease
Maternal exhaustion
Inadequate expulsive effort
Pre-eclampsia
FETAL INDICATIONS
Fetal distress
After coming head to breech
Low birth weight baby
Cord prolapse
Post maturity
10. MISCELLANEOUS INDICATIONS
Prolonged second stage of labour more than two hours and
more than one hour multipara
To reduce the time for second of labour an in
Severe eclampsia
Heart disease of mothers
Post cesarean pregnancy
TYPES OF FORCEPS USED
High forceps
Mid forceps
Low forceps
Outlet forceps
Rotational /Non-rotational forceps
11.
12. 2. Ventouse delivery :- It is an vaccum extractor or
ventouse is used to extract the fetus. Vaccum is an
instrumental device which is designed to assist the
delivery by creating a vaccum between each and the
fetal skull. The pulling force created by vaccum
dragging the cranium.
INDICATIONS
Delay in descent of the head in case of second baby of
twins
Uterine inertia causing delay in late first stage of
labour
As an alternative of forceps used
13. CONTRAINDICATIONS
Malpresentation such as face brow to breech
presentation
Pre-term fetus
Coagulation disorder
CRITERIA REQUIRED TO BE FULFILLED
Head shoulder engaged
Single baby
Cervix should be at least 6cm dilated
COMPLICATIONS
Maternal complications
Fetal complications