Operative vaginal delivery refers to any delivery assisted by vaginal operations such as forceps delivery, ventouse delivery, and destructive operations. Forceps delivery involves using obstetric forceps to extract the fetus when a vaginal birth is inadvisable or impossible without assistance. There are three main types of forceps used: long-curved forceps, short-curved forceps, and Kielland's forceps. Forceps delivery carries risks for both mother and infant if not performed correctly, including lacerations, hemorrhage, and injuries to the fetal head. Proper patient positioning, monitoring, and gentle controlled traction are important to minimize risks when forceps are clinically indicated for delivery assistance.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
This presentation includes all the events , its sign and symptoms about IOL as well as management of women in the first stage of labor and how to assess the women in labor with the help of partograph.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
This presentation includes all the events , its sign and symptoms about IOL as well as management of women in the first stage of labor and how to assess the women in labor with the help of partograph.
Brief overview of operative vaginal delivery as a method of expediting the second stage of labor. The presentation covers both forceps and vacuum delivery including their indications, applications and complications.
Obstetrical Surgeries - Operative vaginal deliveries are accomplished by appl...MariaDavis42
Operative vaginal deliveries are accomplished by applying direct traction on the fetal skull with forceps or by applying traction to the fetal scalp by means of a vacuum extractor
"Nursing is based on an art and science that mould the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs." – Abdellah
ORGANIZATION: According to L. White, "Organization is the arrangement of personnel for facilitating the accomplishment of some agreed purpose through allocation of functions and responsibilities.“
Definition of Professional Organization:
A professional Organization is an organization, usually nonprofit that exists to a particular profession, to protect both public interests and the interests of professionals.
The whole number of people or inhabitants in a country or region” -(Webster’s dictionary)
In sociology, population refers to a collection of human beings.
Scaled down teaching used by a student teacher in a controlled condition of a teacher in order to attain proficiency in a particular teaching skill is called micro teaching
The research approach indicates the basic procedure for conducting research.
Research approach is the technique which the researcher uses to structure a study in order to gather and analyze information relevant to the research question .
A disruptive condition that occurs in response to adverse influences from the internal or external environments
A condition in which the person responds to changes in the normal balanced state
A biological, psychological, social or chemical factor that causes physical or emotional tension and may be a factor in the etiology of certain illnesses.
Most of us have probably become angry on occasion. Let us hope the moment passed quickly, we apologized and moved on. However, anger that is not under control can be extremely harmful, even lethal. It is vital to learn early how to control this emotion.
Stages of labour and alternative therapiesSaima Habeeb
Birth is a normal, healthy part of a woman’s life. This unexplainable happiness is usually accompanied by severe pain due to contractions.
Labour is a health state that most women aspire to, at some point in their lives. The first thought that comes to the mind of an expecting woman regarding her delivery is the pain of labour.
Labour is a normal physiological process, which while should be an occasion for rejoicing
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
3. Operative vaginal delivery refers to any delivery
process which is assisted by vaginal operations.
Delivery by forceps, ventouse and destructive
operations are generally included.
FORCEPS DELIVERY: means extracting the fetus
with the aid of obstetric forceps when it is
inadvisable or impossible for the mother to
complete the delivery by her own efforts.
Forceps are also used to assist the delivery
after coming head in breech presentation and on
occasion to withdraw the head up and out of the
pelvis at cesarean section.
4.
5. Obstetric forceps is a pair of instruments specially
designed to assist extraction of the fetal head and
thereby accomplishing delivery of the fetus.
VARIETIES OF OBSTETRIC FORCEPS: Ever since either
Peter I or Peter II of the Chamberlin family invented the
forceps around AD 1600, more than 700 varieties
were invented or modified. Most of them are of
historical interest only. But only three varieties are
commonly used in present day obstetric practice.
6. These are:-
1.Long-curved forceps with or without axis
traction device
2. Short-curved forceps
3. Kielland’s forceps
The basic construction of these forceps is the
same in that each consists of two halves (blades)
articulated by a lock.
7.
8.
9. Long-curved obstetric forceps is relatively heavy and is
about 37cm (15”) long. In India, Das’s variety (named after
Sir Kedar Nath Das) is commonly used with advantages. It
is comparatively lighter and slightly shorter than its
Western counterpart but is quite suited for the
comparatively small pelvis and small baby of Indian
women.
Measurements:-Length is 37cm (15”);distance in between
the tips is 2.5 cm and widest diameter between the blades
is 9 cm.
i. BLADES: There are two blades and are named right or
left in relation to maternal pelvis in which they lie when
applied.
ii. Shank
iii. Lock
iv. Handle with or without screw.
10.
11. i. Blade: - The blade is fenestrated to facilitate a good
grip of the fetal head. There is usually a slot in the
lower part of the fenestrum of the blades to allow
the upper end of the axis traction rod to be fitted.
The toe of the blade refers to the tip and the heel to
the end of the blade that is attached to the shank.
The blade has got two curves: -
Pelvic curve:-The curve on the edge is to fit more or
less the curve on the axis of the birth canal (curve of
Carus). The front of the forceps is the concave side
of the pelvic curve. Pelvic curve permits ease of
application along the maternal pelvic axis.
Cephalic curve:-It is the curve on the flat surface
which when articulated grasps the fetal head without
compression.
12. ii. Shank:-It is the part between the blade and the lock
and usually measures 6.25 cm(2.5”).It increases the
length of the instrument and thereby, facilitates
locking of the blades outside the vulva.
iii. Lock: -The common method of articulation
consists of a socket system located on the shank at its
junction with the handle (English lock). Such type of
lock requires introduction of the left blade first.
iv. Handle: -The handles are apposed when the blades
are articulated. It measures 12.5 cm(5”). There is a
finger guard on which a finger can be placed during
traction. A screw may be attached usually at the end
(or at the base) of one blade (commonly left). It helps
to keep the blades in position.
13.
14.
15. 3.Kielland’s Forceps
It is a long almost straight (very slight pelvic
curve) obstetric forceps without any axis traction
device. It has got a sliding lock which facilitates
correction of the head. One small knob on each
blade is directed towards the occiput.
16.
17. Type of procedure Criteria
Outlet Forceps Operation (1) Scalp is visible at the introitus without separating the labia
(2) Fetal skull has reached the level of the pelvic floor
(3) Sagittal suture is in direct anteroposterior diameter or in the right
or left occiput anterior or posterior position. ( Wrigley's forceps)
Low Forceps Operation Leading point of the fetal skull (station) is at +2 cm or more but has
not yet reached the pelvic floor. (Simpsons forceps)
Mid Forceps Operation Fetal head is engaged. Leading point of the fetal skull (station) is at
+2 cm or less above the spine.(Kielland's forceps)
High(Excluded) High Head is not engaged. This type is not included in classification
18.
19.
20.
21. Cephalic application:-The blades are applied along
the sides of the head grasping the bi-parietal
diameter in between the widest part of the blades. The
long axis of the blades corresponds more or less to
the occipito – mental plane of the fetal head. It is the
ideal method of application as it has got a negligible
compression effect on the cranium.
Pelvic application:-When the blades of the forceps
are applied on the lateral pelvic walls ignoring the
position of the head, it is called pelvic application. If
the head remains un-rotated, this type of application
puts serious compression effect on the cranium and
thus must be avoided.
22. Delay in the second stage.
Maternal indications
Maternal distress
Pre-eclampsia, eclampsia
Heart disease
Failure to bear down.
Fetal indications(fetal distress).
Cord prolapsed
After coming head of breech.
Post maturity.
23. There are certain conditions which must exist
before delivery can be performed.
The cervix must be fully dilated and effaced.
Membranes must be ruptured.
The head must be engaged with no parts of
head palpable abdominally.
No appreciable Cephalopelvic disproportion.
The bladder must be emptied.
Presence of good uterine contractions as a
safeguard to postpartum hemorrhage.
24. The women’s vulval area is thoroughly cleaned and
draped with sterile towels using aseptic technique.
The bladder is emptied using a straight catheter.
A vaginal examination is performed by the
obstetrician to confirm the station and exact
position of the fetal head.
A pudental block, supplemented by perineal and
labial infiltration with 1 % lignocaine hydrochloride,
is given to produce effective local anesthesia.
An episiotomy may be done prior to introduction of
the blades or during traction when the perineum
becomes bulged and thinned out by the advanced
head.
The forceps are identified as left or right by
assembling them briefly before proceeding.
25. The left blade is passed gently between the perineum
and fetal head with the first two figures of the
operator’s hand lying alongside the fetal head
protecting the maternal tissue. The tip of the forceps
blade slides lightly over the head, in to the hollow of
the sacrum and is then ‘wandered’ to the left side of
the pelvis where it should sit alongside the head.
The procedure is repeated with the right blade until
it sits on the right of the pelvis.
It should then be easy to lock the two blades and
there should be little or no gap between the handles.
A significant gap suggests that the forceps are
wrongly positioned and they should be reapplied after
carefully checking the position of head.
26. As soon as the operator is ready and the uterus
contracts, the woman is encouraged to push. To
supplement her efforts the obstetrician exerts steady,
downwards traction on the forceps. Traction is released
between contractions. Intermittent traction is continued in
a downward and backward direction until the head comes
to the perineum. The pull is then directed horizontally
straight towards the operator until the head is almost
crowned. The direction of pull is gradually changed
towards the mother’s abdomen to deliver the head by
extension.
The blades are removed one after the other, the right one
first.
Following the birth of the head, usual procedures are to
be followed as in normal delivery. Intravenous methergine
0.2mg is to be administered with the delivery of the
anterior should. Episiotomy is repaired as quickly as
possible and the woman made comfortable.
27.
28. The women should be prepared in advances for the
possibility of a forceps delivery.
Full explanation of the procedure and the need for it
must be given to the woman.
Once the decision has been made, adequate and
appropriate analgesia must be offered.
The women should be placed in lithotomy position.
Both legs must be placed simultaneously to avoid
strain on the woman’s back and hips.
29. During the application of the forceps, the
woman should be given full support and
attention.
The fetal heart rate is to be monitored
throughout.
Preparations must also be done for the baby
including equipment for resuscitation. In some
hospitals a pediatrician will also be present.
30. The hazards of the forceps operation are mostly
related to the faulty technique and to the
indication for which the forceps are applied.
In the mother
Immediate
Injury
Extension of the episiotomy towards rectum or
upwards up to the vault of vagina
Vaginal lacerations
Cervical tear especially when applied through an
incompletely dilated cervix.
Bruising and trauma to the urethra.
31. Postpartum hemorrhage due to trauma, or
atonic uterus related to prolonged labor or
effects of anesthesia.
Shock due to blood loss, prolonged labor and
dehydration.
Sepsis due to devitalization of local tissues and
improper asepsis.
Late complications
Chronic low backache due to tension imposed
on softened ligaments of lumbosacral or
sacroiliac joints during lithotomy position.
Genital prolapse or stress incontinence.
32. In the infant
Immediate
Asphyxia due to intracranial stress out of
prolonged compression.
Intracranial hemorrhage due to misapplication
of the blades.
Cephalhematoma
Facial palsy due to damage to facial nerve.
Abrasions on the soft tissues of the face and
forehead by the forceps blade, severe bruising
will cause marked jaundice.
Tentorial fear from compression of the fetal
head by the forceps.
33.
34.
35. Prevention: It is a preventable condition. Only
through skill and judgment, proper selection of the
case ideal for forceps can be identified. Even if
applied in wrong cases, one should resist the
temptation to give forcible traction in an attempt to
hide the mistake.
Management:
(1)To assess the effect on the mother and the fetus.
(2)To start a Ringer’s solution drip and to arrange
for blood transfusion, if required.
(3)To administer parenteral antibiotic.
(4)To exclude rupture of the uterus.
(5) The procedure is abandoned and delivery is done
by cesarean section
(6) Laparotomy should be done in a case with rupture
of uterus.