This document discusses obstetric forceps, which are metal instruments used to extract a baby's head during delivery. It describes different types of forceps and their proper application techniques. Forceps are indicated for prolonged second stage of labor, maternal distress, or fetal distress. Correct application involves inserting one blade along each side of the baby's head. Potential complications include laceration, hemorrhage, nerve injury, or problems for the baby such as skull fractures. Failure to deliver with forceps may require removal and assessment to determine if cesarean section is needed.
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
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
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
under and post graduate best presentation ever about the assisted vaginal delivery,operative vaginal delivery, or instrumental vaginal delivery.
done by waill salan al.timeemi/stager 2014-2015/ Iraq-al.qadisiyyah college of medicine.
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.
4. Action of the Forceps Traction: is the main action. Rotation: in deep transverse arrest, persistent occipito-posterior and mento-posterior. www.freelivedoctor.com
5. Indications of Forceps Delivery Prolonged 2nd stage It is prolongation for more than 1 hour in primigravidae or 30 minutes in multiparae. This may be due to: * Inertia and poor voluntary bearing down. * Large foetus. * Rigid perineum. * Malpositions: persistent occipito-posterior and deep transverse arrest. www.freelivedoctor.com
6. Maternal indications * Maternal distress manifested by: >Exhaustion. > Pulse >100 beats / min. > Temperature >38oC . > Signs of dehydration. * Maternal diseases as: > Heart disease. > Pulmonary T.B. > Pre-eclampsia and eclampsia. www.freelivedoctor.com
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8. During caesarean sectionOne (used as a lever) or the two blades may be used to extract the head through the uterine incision.www.freelivedoctor.com
10. Pre-requisites for Forceps Application * Anaesthesia: general, epidural, spinal or pudendal block. * Adequate pelvic outlet. * Aseptic measures. * Bladder and Bowel evacuation. * Contractions of the uterus should be present. * Dilatation of the cervix should be fully. * Engaged head. www.freelivedoctor.com
11. Pre-requisites for Forceps Application * Forewater rupture. * Favourable position and presentation: >Occipito-anterior. >Occipito-posterior > Face presentation. >After-coming head in breech. www.freelivedoctor.com
12. Types of Forceps Application * Cephalic application: the forceps is applied on the sides of the foetal head in the mento-vertical diameter so injury of the foetal face, eyes and facial nerve is avoided . * Pelvic application: The forceps is applied along the maternal pelvic wall irrespective to the position of the head. It is easier for application but carries a great risk of foetal injuries. * Cephalo-pelvic application: It is the ideal application and possible when the occiput is directly anterior or posterior or in direct mento-anterior position. www.freelivedoctor.com
13. How to know Right and Left Blades Putting in consideration that the mother is in the lithotomy position, the blade will be applied with the pelvic curve directed anteriorly and the cephalic curve directed medially. If the blade will be applied to the left maternal side it is a left blade and vice versa. www.freelivedoctor.com
14. Technique of Forceps Delivery In occipito- anterior position * The left blade is applied first. It is held by its handle between the thumb and fingers of the left hand almost parallel with the right inguinal ligament and passed along the left side of the maternal pelvis between the guiding palm of the right hand and foetal head. * As the blade passes into the birth canal the handle is carried backwards and towards the midline. It is now the lower blade. www.freelivedoctor.com
15. Technique of Forceps Delivery * The fingers of the left hand are introduced along the right side of the pelvis and the right blade is held and passed in the same manner. It is now the upper blade. * The 2 blades should be locked easily, if not this means that they were not correctly applied and should be removed and re-assess the position of the head. www.freelivedoctor.com
16. Clinical checks for correct forceps application: * The sagittal suture lies in the midline of the shanks. * The operator cannot place more than a finger tip between the fenestration of the blade and the foetal head. * The posterior fontanelle is not more than one finger- breadth above the plane of the shanks. www.freelivedoctor.com
17. Traction should be: * gentle by the force of the arm only, * intermittent with uterine contractions only, * in correct direction i.e. downwards and backwards till the occiput appears at the vulva, then downwards and forwards. * The 2 blades are unlocked between contractions to minimise the period of head compression. www.freelivedoctor.com
18. Kielland forceps in deep transverse arrest The forceps is locked outside with the knobs towards the occiput to know the anterior blade. The anterior blade is applied first by one of the following methods: www.freelivedoctor.com
19. The wandering method: The anterior blade is guided into the lateral side of the pelvis with the cephalic curve facing the foetal head. It is then slid over the forehead to fit against the anterior parietal eminence. The direct method: when the head is low down in the pelvis, the anterior blade is slid between the head and symphysis pubis with the cephalic curve facing the foetal head. The old (classical) method: The anterior blade is applied with the cephalic curve towards the symphysis pubis then it is rotated 1800 to fit with the head. This method is not recommended as the lower uterine segment and bladder may be injured. www.freelivedoctor.com
20. The posterior blade is applied along the concavity of the sacrum. The 2 blades are locked, head is rotated and extracted as occipito-anterior. www.freelivedoctor.com
21. Complications of Forceps Delivery Maternal complications Foetal complications www.freelivedoctor.com
23. Maternal complications Bone injuries: to pelvic joints, coccyx or symphysis pubis. Pelvic nerve injuries. Postpartum haemorrhage: due to lacerations or atony. Puerperal infections. Remote effects: genital prolapse, stress incontinence, cervical incompetence and genito-urinary fistulas. www.freelivedoctor.com
24. Foetal complications Fracture of the skull. Cephalohaematoma. Intracranial haemorrhage. Facial nerve palsy. Trauma to the face, eyes or scalp. Asphyxia due to: > intracranial haemorrhage or, > cord compression between the head and the forceps. www.freelivedoctor.com
25. FAILED FORCEPS Failure to extract the foetus by the forceps which may be due to failure to apply the forceps or to deliver the head with it www.freelivedoctor.com
26. FAILED FORCEPS Causes * Cephalo-pelvic disproportion. * Contracted outlet. * Incomplete cervical dilatation. * Constriction ring. * Head is not engaged. * Malpositions as persistent occipito-posterior. *Malpresentations as brow. * Foetal congenital anomalies as hydrocephalus, ascitis and conjoined twins. www.freelivedoctor.com
27. Management * Reassessment: The forceps is removed and the patient is re-examined to detect the cause and correct it if possible. * Caesarean section: is indicated in uncorrectable causes as cephalo-pelvic disproportion, and contracted outlet. * Exploration of the birth canal: for any injuries. www.freelivedoctor.com
