IVD is also known as OVD or Assisted vaginal delivery It refers to the vaginal birth with use of forceps or vacuum extractor Goal is to facilitate or accelerate the delivery with a minimum of maternal and neonatal morbidity It should only be performed when all the safety criteria have been met and benefits outweigh the risks Incidence varies widely both within and between countries The rate in nulliparous women is as high as 30% In UK b/w 10% to 15% of deliveries are assisted with forceps or vacuum According to the JPMA: The incidence of IVD ranges b/w 10% to 20% of all deliveries in our country its indications Safety criteria Full abdomen and vaginal examination Head is ≤ 1/5 palpable per abdomen ( in most cases 0/5) Cervix is fully dilated and the membrane ruptured Station at the level of ischial spine or below (0/+1/+2/+3) Exact position of the head has been determined so correct placement of the instrument can be achieved Preparation of mother Clear explanation given and informed consent obtained Trust has been established and women offers full cooperation Maternal bladder has been emptied recently In-dwelling catheter has been removed or balloon deflated Preparation of staff Operator has knowledge , experience and skill necessary Adequate facilities are available and access to an OT Back-up plan in place in case of failure to delivery For midpelvic deliveries, theatre staff should be available immediately to allow a C-section to be performed without delay Personnel present that are trained in neonatal resuscitation And much more

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2. IVD is also known as OVD or Assisted vaginal delivery
It refers to the vaginal birth with use of forceps or vacuum extractor
Goal is to facilitate or accelerate the delivery with a minimum of maternal and neonatal
morbidity
It should only be performed when all the safety criteria have been met and benefits
outweigh the risks

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MATERNAL
FETAL
COMBINED:

5. • FULL ABDOMEN AND VAGINAL EXAMINATION
 HEAD IS ≤ 1/5 PALPABLE PER ABDOMEN ( IN MOST CASES 0/5)
 CERVIX IS FULLY DILATED AND THE MEMBRANE RUPTURED
 STATION AT THE LEVEL OF ISCHIAL SPINE OR BELOW (0/+1/+2/+3)
 EXACT POSITION OF THE HEAD HAS BEEN DETERMINED SO CORRECT PLACEMENT OF THE
INSTRUMENT CAN BE ACHIEVED

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17. MATERNAL: FETAL ( RARE)

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25. 1.MATERNAL: 2.FETAL: