Operative vaginal delivery refers to using forceps or vacuum to extract the fetus from the vagina during birth. Forceps are metal instruments that grasp the fetal head, while vacuum uses suction from a cup placed on the scalp. Both have specific criteria for use including full cervical dilation and indications like fetal distress or prolonged second stage of labor. The procedure involves applying the instrument and applying gentle traction to guide the head through the birth canal. Potential risks include laceration, hemorrhage, and rare complications like skull fractures. Failure may occur due to disproportion, incorrect technique, or inability to maintain the vacuum seal.
This document provides an overview of instrumental deliveries including forceps delivery, vacuum extraction, and destructive vaginal deliveries. It defines instrumental deliveries as births assisted by forceps or vacuum and notes their indications include hastening delivery when labor is obstructed or prolonged. Complications of instrumental deliveries for both mother and baby are described. The document then details the types, prerequisites, applications and complications of forceps delivery, vacuum extraction, and various destructive vaginal procedures.
Forceps delivery and vacuum extraction are operative vaginal deliveries that can be used when a vaginal delivery is not progressing normally. Forceps are metal instruments with curved blades that grasp the fetal head, while vacuum extraction uses suction from a cup placed on the fetal scalp to assist delivery. Both have specific prerequisites, techniques, and risks that require an experienced provider to minimize risks to the mother and baby. Complications can include fetal scalp injuries, so careful application and monitoring are important.
This document provides an overview of vacuum-assisted delivery, including:
1) The introduction, instruments, advantages, indications, techniques, rules, procedures, disadvantages, contraindications, and complications of vacuum-assisted delivery.
2) Details on the components of vacuum devices, classification of assisted delivery, advantages of vacuum over forceps, and the 10 step procedure for vacuum delivery from asking for help to releasing the vacuum once the baby's jaw can be reached.
3) Potential maternal and fetal complications that can arise from technical errors or other issues with the procedure. Management, documentation and references are also covered.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
This document discusses instrumental delivery methods including forceps and vacuum extraction. It provides details on:
- The history and components of obstetric forceps, including the curved blades, shanks, locks, and handles.
- Indications for forceps delivery including maternal distress, fetal distress, prolonged second stage of labor, and certain medical complications.
- Prerequisites for safe forceps use such as fetal presentation, engagement and position of the head, cervical dilation, and pelvic adequacy.
- Steps for applying forceps including identification of landmarks, application of blades, locking, and controlled extraction of the head.
- Complications of both forceps and vacuum extraction for both mother and
This document discusses various obstetric operations and procedures including induction of labor, forceps delivery, ventouse delivery, and version. It provides information on:
- The different methods of inducing labor, including medical, surgical, and combined methods using prostaglandins, oxytocin, amniotomy, and more.
- The prerequisites, steps, complications, and nursing role in induction of labor, forceps delivery, and ventouse delivery.
- The types, indications, contraindications, and procedures for external and internal versions.
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.
Instrumental delivery refers to using forceps or vacuum to assist in vaginal birth. Historically it was used to save mothers' lives during obstructed labor but now focuses on fetal/neonatal impact. Vacuum is generally safer for mothers while forceps are safer for babies. Complications can include lacerations, hemorrhage, and fractures for both. Destructive procedures like craniotomy reduce the fetal size for delivery but carry infection risks and leave the mother with an intact uterus. Proper technique and indications are important to minimize risks.
This document provides an overview of instrumental deliveries including forceps delivery, vacuum extraction, and destructive vaginal deliveries. It defines instrumental deliveries as births assisted by forceps or vacuum and notes their indications include hastening delivery when labor is obstructed or prolonged. Complications of instrumental deliveries for both mother and baby are described. The document then details the types, prerequisites, applications and complications of forceps delivery, vacuum extraction, and various destructive vaginal procedures.
Forceps delivery and vacuum extraction are operative vaginal deliveries that can be used when a vaginal delivery is not progressing normally. Forceps are metal instruments with curved blades that grasp the fetal head, while vacuum extraction uses suction from a cup placed on the fetal scalp to assist delivery. Both have specific prerequisites, techniques, and risks that require an experienced provider to minimize risks to the mother and baby. Complications can include fetal scalp injuries, so careful application and monitoring are important.
This document provides an overview of vacuum-assisted delivery, including:
1) The introduction, instruments, advantages, indications, techniques, rules, procedures, disadvantages, contraindications, and complications of vacuum-assisted delivery.
2) Details on the components of vacuum devices, classification of assisted delivery, advantages of vacuum over forceps, and the 10 step procedure for vacuum delivery from asking for help to releasing the vacuum once the baby's jaw can be reached.
3) Potential maternal and fetal complications that can arise from technical errors or other issues with the procedure. Management, documentation and references are also covered.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
This document discusses instrumental delivery methods including forceps and vacuum extraction. It provides details on:
- The history and components of obstetric forceps, including the curved blades, shanks, locks, and handles.
- Indications for forceps delivery including maternal distress, fetal distress, prolonged second stage of labor, and certain medical complications.
- Prerequisites for safe forceps use such as fetal presentation, engagement and position of the head, cervical dilation, and pelvic adequacy.
- Steps for applying forceps including identification of landmarks, application of blades, locking, and controlled extraction of the head.
- Complications of both forceps and vacuum extraction for both mother and
This document discusses various obstetric operations and procedures including induction of labor, forceps delivery, ventouse delivery, and version. It provides information on:
- The different methods of inducing labor, including medical, surgical, and combined methods using prostaglandins, oxytocin, amniotomy, and more.
- The prerequisites, steps, complications, and nursing role in induction of labor, forceps delivery, and ventouse delivery.
- The types, indications, contraindications, and procedures for external and internal versions.
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.
Instrumental delivery refers to using forceps or vacuum to assist in vaginal birth. Historically it was used to save mothers' lives during obstructed labor but now focuses on fetal/neonatal impact. Vacuum is generally safer for mothers while forceps are safer for babies. Complications can include lacerations, hemorrhage, and fractures for both. Destructive procedures like craniotomy reduce the fetal size for delivery but carry infection risks and leave the mother with an intact uterus. Proper technique and indications are important to minimize risks.
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
Operative procedures in obstetrics often require aseptic techniques and protocols. Forceps deliveries and vacuum extractions help deliver babies when natural delivery is not possible or advisable. Forceps come in various shapes and sizes and are applied at different levels of the fetal head. Caesarean sections are performed when delivery through the birth canal would endanger the mother or baby. Lower segment incisions are now preferred. Destructive procedures like craniotomy perforate the fetal skull to allow delivery of a dead baby when labor is obstructed.
Forceps delivery is an operative vaginal delivery procedure that uses obstetric forceps to assist in the extraction of the fetal head. Forceps have curved blades that fit around the fetal head to allow the operator to apply gentle traction. Forceps delivery is indicated when there are signs of fetal distress, prolonged second stage of labor, or maternal medical complications. Risks include laceration, hemorrhage, and injuries to the mother or baby. Proper technique and only performing the procedure when fully trained can help minimize risks.
Forceps delivery Guest lecture presented at thr West Zone YUVA FOGSI Udaipur in July 2018, Dfination, Clasification, Prerequisites, Indications, Contraindications, Complication Maternal and Fetal,
This document discusses oocyte pick up and embryo transfer procedures. It describes the equipment, techniques, tips, and potential complications for oocyte pick up, which involves using ultrasound-guided needles to aspirate follicles and retrieve oocytes. It also outlines the timing, catheters, techniques, ultrasound guidance, and factors considered for embryo transfer, which involves placing embryos into the uterine cavity. Mock embryo transfers are recommended to practice catheter placement before the real procedure.
The document provides an overview of the partograph, which is a graphical record used to monitor the progress of labor and the condition of the mother and fetus. It describes the history and development of the partograph, including Friedman's original partogram from 1954 and later modifications by Philpott and Castle that introduced alert and action lines. The WHO partograph is explained in detail, outlining its components for monitoring fetal condition, labor progress, and maternal condition. Guidelines are provided for normal labor progression and management based on the partograph, as well as how to identify and respond to abnormal labor progress. Key considerations for using oxytocin augmentation are also reviewed.
The document provides an overview of the WHO partograph, which is a graphical record used to monitor the progress of labor and the condition of the mother and fetus. It describes the history and development of the partograph, including Friedman's original design from 1954 and later additions by Philpott and Castle in 1972, who introduced the "alert line" and "action line". The document then explains the components, objectives, and proper use and interpretation of the partograph to monitor labor progress and determine if intervention is needed.
The document provides information on using the WHO partograph to monitor labor progress. It describes the components of the partograph including fetal condition, labor progress, and maternal condition. It explains how to interpret the partograph and what actions to take at different stages, such as transferring a woman if she crosses the alert line or making management decisions if she reaches the action line. The purpose is to detect abnormal labor progress early so issues can be addressed promptly to prevent complications for mother and baby.
This document provides information about the WHO partograph, including:
- The partograph is a graphical record used to monitor labor progress and the condition of the mother and fetus. It was developed by the WHO.
- The history of the partograph is described, from Friedman's original version in 1954 to later refinements by Philpott and Castle in 1972 who introduced alert and action lines.
- The components of the modern partograph are outlined, including sections to monitor fetal condition, labor progress, and maternal condition. Key indicators like cervical dilation, fetal position, and uterine contractions are plotted over time.
- Guidelines for interpreting labor progress using the partograph and determining appropriate actions are provided, such as transferring or
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.
This document describes forceps-assisted deliveries. It defines obstetric forceps as a double-bladed metal instrument used to extract the fetal head. It describes the parts of forceps including the blades, shanks, locks and handles. It discusses different types of forceps and their uses. It outlines the indications, prerequisites, technique and contraindications for a forceps-assisted delivery. Key steps include inserting the blades one at a time, applying traction in line with uterine contractions to deliver the baby. Training and experience of the operator are important to minimize risks.
This document provides information about the WHO partograph, including:
- The partograph is a graphical record used to monitor the progress of labor and the condition of the mother and fetus.
- It was developed by the WHO to allow health workers to monitor labor and identify issues that may require intervention or transfer to a higher level of care.
- The partograph includes sections to record fetal condition, progress of labor including cervical dilation over time, and maternal condition. Crossing lines on the graph indicate when closer monitoring or actions are required.
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
This document discusses clinical pelvimetry and forceps-assisted vaginal delivery. It begins by outlining the objectives and key anatomical features assessed in a clinical pelvimetry exam. It then discusses the different types of forceps, indications for their use, application techniques, and complications. It emphasizes the importance of training residents on forceps use through lectures, workshops and opportunities to apply different forceps during cesarean deliveries in order to graduate with skills for operative vaginal delivery.
1. The document discusses various operative obstetric procedures including vaginal operations like forceps delivery, breech extraction, and vacuum extraction as well as abdominal operations like cesarean section and postpartum hysterectomy.
2. Forceps delivery classifications include outlet, low, mid, and high forceps. Indications, techniques, and complications are described.
3. Breech delivery techniques include the Pinard maneuver and total breech extraction. Risks to the mother and fetus are outlined.
4. Vacuum extraction provides an alternative to forceps delivery using suction to assist delivery. Placement of the suction cup is critical for success.
1) The document summarizes the management of normal labor and the use of the partograph to monitor labor. It describes the stages of labor, mechanisms of labor, and complications that can occur.
2) The partograph is a graphic record that aids in early detection of problems in the mother and fetus. It includes monitoring of cervical dilation, fetal descent, uterine contractions, and fetal and maternal conditions.
3) Key principles of the WHO partograph include commencing the active phase at 3cm dilation, the latent phase not exceeding 8 hours, and cervical dilation slowing to less than 1cm/hr requiring intervention.
Forceps delivery and vacuum extraction are common operative vaginal delivery techniques used to expedite delivery when needed. Forceps have curved blades that grasp the fetal head, while vacuum extraction uses suction from a soft silicone cup placed on the fetal scalp. Both require the fetus to be fully engaged and have certain prerequisites checked before use, including maternal and fetal condition, cervical dilation, and anesthesia. Complications can include increased maternal and neonatal injury compared to spontaneous vaginal delivery, so these techniques aim to minimize risks while aiding delivery.
The document summarizes various abnormalities that can occur during labour and their management. It discusses prolonged latent phase of labour, poor progress in the active phase, meconium staining of amniotic fluid, prolonged second stage of labour, vacuum extraction, fetal distress, cord prolapse, and shoulder dystocia. For each issue, it provides details on how to assess and manage the situation, including administering drugs, changing positioning, accelerating delivery, or transferring to a hospital if needed. The goal is to safely resolve any problems and deliver a healthy baby.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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
Operative procedures in obstetrics often require aseptic techniques and protocols. Forceps deliveries and vacuum extractions help deliver babies when natural delivery is not possible or advisable. Forceps come in various shapes and sizes and are applied at different levels of the fetal head. Caesarean sections are performed when delivery through the birth canal would endanger the mother or baby. Lower segment incisions are now preferred. Destructive procedures like craniotomy perforate the fetal skull to allow delivery of a dead baby when labor is obstructed.
Forceps delivery is an operative vaginal delivery procedure that uses obstetric forceps to assist in the extraction of the fetal head. Forceps have curved blades that fit around the fetal head to allow the operator to apply gentle traction. Forceps delivery is indicated when there are signs of fetal distress, prolonged second stage of labor, or maternal medical complications. Risks include laceration, hemorrhage, and injuries to the mother or baby. Proper technique and only performing the procedure when fully trained can help minimize risks.
Forceps delivery Guest lecture presented at thr West Zone YUVA FOGSI Udaipur in July 2018, Dfination, Clasification, Prerequisites, Indications, Contraindications, Complication Maternal and Fetal,
This document discusses oocyte pick up and embryo transfer procedures. It describes the equipment, techniques, tips, and potential complications for oocyte pick up, which involves using ultrasound-guided needles to aspirate follicles and retrieve oocytes. It also outlines the timing, catheters, techniques, ultrasound guidance, and factors considered for embryo transfer, which involves placing embryos into the uterine cavity. Mock embryo transfers are recommended to practice catheter placement before the real procedure.
The document provides an overview of the partograph, which is a graphical record used to monitor the progress of labor and the condition of the mother and fetus. It describes the history and development of the partograph, including Friedman's original partogram from 1954 and later modifications by Philpott and Castle that introduced alert and action lines. The WHO partograph is explained in detail, outlining its components for monitoring fetal condition, labor progress, and maternal condition. Guidelines are provided for normal labor progression and management based on the partograph, as well as how to identify and respond to abnormal labor progress. Key considerations for using oxytocin augmentation are also reviewed.
The document provides an overview of the WHO partograph, which is a graphical record used to monitor the progress of labor and the condition of the mother and fetus. It describes the history and development of the partograph, including Friedman's original design from 1954 and later additions by Philpott and Castle in 1972, who introduced the "alert line" and "action line". The document then explains the components, objectives, and proper use and interpretation of the partograph to monitor labor progress and determine if intervention is needed.
The document provides information on using the WHO partograph to monitor labor progress. It describes the components of the partograph including fetal condition, labor progress, and maternal condition. It explains how to interpret the partograph and what actions to take at different stages, such as transferring a woman if she crosses the alert line or making management decisions if she reaches the action line. The purpose is to detect abnormal labor progress early so issues can be addressed promptly to prevent complications for mother and baby.
This document provides information about the WHO partograph, including:
- The partograph is a graphical record used to monitor labor progress and the condition of the mother and fetus. It was developed by the WHO.
- The history of the partograph is described, from Friedman's original version in 1954 to later refinements by Philpott and Castle in 1972 who introduced alert and action lines.
- The components of the modern partograph are outlined, including sections to monitor fetal condition, labor progress, and maternal condition. Key indicators like cervical dilation, fetal position, and uterine contractions are plotted over time.
- Guidelines for interpreting labor progress using the partograph and determining appropriate actions are provided, such as transferring or
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.
This document describes forceps-assisted deliveries. It defines obstetric forceps as a double-bladed metal instrument used to extract the fetal head. It describes the parts of forceps including the blades, shanks, locks and handles. It discusses different types of forceps and their uses. It outlines the indications, prerequisites, technique and contraindications for a forceps-assisted delivery. Key steps include inserting the blades one at a time, applying traction in line with uterine contractions to deliver the baby. Training and experience of the operator are important to minimize risks.
This document provides information about the WHO partograph, including:
- The partograph is a graphical record used to monitor the progress of labor and the condition of the mother and fetus.
- It was developed by the WHO to allow health workers to monitor labor and identify issues that may require intervention or transfer to a higher level of care.
- The partograph includes sections to record fetal condition, progress of labor including cervical dilation over time, and maternal condition. Crossing lines on the graph indicate when closer monitoring or actions are required.
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
This document discusses clinical pelvimetry and forceps-assisted vaginal delivery. It begins by outlining the objectives and key anatomical features assessed in a clinical pelvimetry exam. It then discusses the different types of forceps, indications for their use, application techniques, and complications. It emphasizes the importance of training residents on forceps use through lectures, workshops and opportunities to apply different forceps during cesarean deliveries in order to graduate with skills for operative vaginal delivery.
1. The document discusses various operative obstetric procedures including vaginal operations like forceps delivery, breech extraction, and vacuum extraction as well as abdominal operations like cesarean section and postpartum hysterectomy.
2. Forceps delivery classifications include outlet, low, mid, and high forceps. Indications, techniques, and complications are described.
3. Breech delivery techniques include the Pinard maneuver and total breech extraction. Risks to the mother and fetus are outlined.
4. Vacuum extraction provides an alternative to forceps delivery using suction to assist delivery. Placement of the suction cup is critical for success.
1) The document summarizes the management of normal labor and the use of the partograph to monitor labor. It describes the stages of labor, mechanisms of labor, and complications that can occur.
2) The partograph is a graphic record that aids in early detection of problems in the mother and fetus. It includes monitoring of cervical dilation, fetal descent, uterine contractions, and fetal and maternal conditions.
3) Key principles of the WHO partograph include commencing the active phase at 3cm dilation, the latent phase not exceeding 8 hours, and cervical dilation slowing to less than 1cm/hr requiring intervention.
Forceps delivery and vacuum extraction are common operative vaginal delivery techniques used to expedite delivery when needed. Forceps have curved blades that grasp the fetal head, while vacuum extraction uses suction from a soft silicone cup placed on the fetal scalp. Both require the fetus to be fully engaged and have certain prerequisites checked before use, including maternal and fetal condition, cervical dilation, and anesthesia. Complications can include increased maternal and neonatal injury compared to spontaneous vaginal delivery, so these techniques aim to minimize risks while aiding delivery.
The document summarizes various abnormalities that can occur during labour and their management. It discusses prolonged latent phase of labour, poor progress in the active phase, meconium staining of amniotic fluid, prolonged second stage of labour, vacuum extraction, fetal distress, cord prolapse, and shoulder dystocia. For each issue, it provides details on how to assess and manage the situation, including administering drugs, changing positioning, accelerating delivery, or transferring to a hospital if needed. The goal is to safely resolve any problems and deliver a healthy baby.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
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• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
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2. Operative vaginal delivery
Operative vaginal birth refers to a birth in
which the operator uses forceps , a
vacuum device, or another instrument to
extract the fetus from the vagina, with or
without the assistance of maternal pushing
3. Indication
Fetal
1 fetal distress
2 after coming head of
breech
3 suspicion of fetal
compromise
Maternal
1. Prolonged second stage of labour
( nulliparous 2 hours, multiparous 1 hour)
2. Exhaustion /distress
3. Medical indications to shorten second
stage(severe PE , cardiac disease , post
cesarean)
4. When expulsive efforts are to be
avoided( cerebrovascular disease, cardiac
disease, spinal cord injuries)
8. History
• The Chamberlens were innovators, opportunists and entrepreneurs of forceps.
• In fact, the instrument was kept secret for 150 years by the Chamberlen family,
although there is evidence for its presence as far back as 1634.
• Models derived from the Chamberlen instrument finally appeared gradually in England
and Scotland in 1735. About 100 years after the invention of the forceps by Peter
Chamberlen Sr. a surgeon by the name of Jean Palfyn presented his obstetric forceps
to the Paris Academy of Sciences in 1723.
• • They contained parallel blades and were called the Hands of Palfyn.
9. • Tarnier's idea was to "split" mechanically the grabbing of the fetal head
(between the forceps blades) on which the operator does not intervene after
their correct positioning, from a mechanical accessory set on the forceps
itself, the "tractor" on which the operator exercises traction needed to pull
down the fetal head in the correct axis of the pelvic excavation.
• Tarnier forceps (and its multiple derivatives under other names) remained the
most widely used system in the world until the development of the cesarean
section
12. Classification of operative vaginal delivery
Outlet
• Fetal scalp visible without separating the labia
• Fetal skull has reached the pelvic floor
• Sagittal suture is in the anterio-posterior diameter or right or left occiput anterior
or posterior position (rotation does not exceed 45)
• Fetal head is at or on the perineum
13. Low
• Leading point of the skull (not caput) is at station plus 2 or more and not on the pelvic
floor
• Two subdivisions:
• rotation of 45° or less from the occipito-anterior position
• rotation of more than 45° including the octipito-posterior position
14. Mid
• Fetal head is no more than 1/sth palpable per abdomen
• Leading point of the skull is above station plus 2 but not above the ischial spines
• Two subdivisions:
• rotation of 45° or less from the occipito-anterior position
• rotation of more than 45° including the occipito-posterior position
15. High
• Not included in the classification as operative vaginal delivery is not recommended in
this situation where the head is 2/5th or more
• palpable abdominally and the presenting part is above the level of the ischial spines
19. Relative
• unfavourable attitude of fetal head
• rotation >45° from occiput anterior or occiput posterior (vacuum)
• mid-pelvic station
• fetal prematurity
20. Preparation
• Team preparation
• Confirm consent
• Ensure adequate space for operator to sit or kneel
• Check swabs , instruments and other essential equipments
• Ensure adequate analgesia
• Patient position
• Careful clinical assessment
21. Procedure
• Assemble the forceps
• Application of blades
• Checking the application
• Traction
• Removal
28. Application of blades in LOA &ROA
• INSERTION OF BLADES REMAINING SAME
• IT SHOULD BE ENSURED BLADES REMAIN PARALLEL TO FETAL SAGITTAL
SUTURE
• ROTATION FROM LOA/ROA TO DOA can be achieved prior to traction
• Handle should be elevatedbt 30 to 40 degree ( towards 1 o’clock to 2 o’clock position
in LOA and 10 o’clock to 11o’clock position in ROA)
• Gentle rotation should be given between the contractions
31. Forceps for after coming head of breech
• Indications
• Prophylactic i.e. to prevent sudden compression and decompression of after coming
head
• Arrest of after coming head
• Different forceps which can be used
• Long Pipers forceps
• Simpsons long forceps
• Kielland's forceps
34. Failed operative delivery
• Forceps do not lock
• Forceps slip after application
• While effecting rotation only blades rotate
• Extraction is not possible
• •There is morbidity to motality to fetus and mother
• • Application before full dilatation of cervix
• • Gross Cephalopelvic Disproportion
• • DTA
• • Undiagnosed hydrocephalus
• • Contraction ring grasping the fetus
40. History
• • James Young Simpsom devised double valved piston with a metal cup - like a breast
pump
• Tage Malmstorm in 1953 described the most successful model
• Pelosi, Apuzzio introduced Sialistic Cup with metal traction
41. Types of vaccum
• Malmstorms Vacuum Extractor
Parts
Metal Cup with Plates (3.4.5.6 mm)
Traction Chain attached to the plate
• Traction Handle
Pressure rubber tube which encloses the traction chain
Vacuum Bottle with pressure gauge
• Vacuum pump
• Bird's Modification -
In this Vacuum tube is attached to the opening near periphery of
the cup and the traction chain to the hook in the cere of the cup
Flat metal plate and the pin have been discarded
42.
43. • Soft Cup -Bell shaped 6.5 mm. Produces symmetric, less cosmetic alarming caput
succundaneum and less scalp abrasion
• • Silastic Cups - Pliable, softer, less traumatic and safer. Described by Koyabashi
• Plastic Cups (Mityvac) - Consists of disposable plastic cup and handle, suction tube
and hand pump. It builds pressure quickly and can be used evn in the absence of
electricity.
44. Type of cup application
• Flexing Median
• Flexing Paramedian
• Deflexing Median
• Deflexing Paramedian
45.
46.
47. • Shortening second stage of labour
• Maternal Exhaustion
• Presumed fetal distress
• Occipito- Posterior position
• To deliver second twin if head is presenting part
INDICATIONS
48. CONTRADICATION
Absolute
• Operator inexperience
• Inability to properly attach
• Inadequate trial of Labour
• High fetal head
• Malpositions
• Aftercoming head of breech
• Known fetal coagulation defect
Relative
-
• Prematurity
• Intrauterine fetal Demise
• Congenital Anomalies
• 'Prior Scalp Sampling
49. CHIGNON FORMATION
• A chignon is a temporary swelling left on an infant's head after a ventouse suction cap
has been used to deliver him or her
Chignon in french : a knot of hair that is worn at the back of the head
50. Procedure
• • A proper vacuum extraction depends on
• The accuracy of the cup application
• The traction technique
• Fetal cranial position
• Cup design
• • The feto-pelvic relationship
51. • Patient is in litotomy position
• Written informen consent taken
• Bladder is emptied
• The position ,station and the attitude of the fetal head is verified
• Phantom application is performed before an attempt
52.
53. • Place the cup
• The practitioner spreads the labia and introduces the bell shaped cup by compressing
and inserting it into the vagina while angling the device posteriorly.
• When contact is made with the fetal head, the center of the cup is placed over the
flexion point and symmetrically across the sagittal suture
• After correct placement of the cup is confirmed, vacuum pressure should be raised to
100 to 150 mmHg to maintain the cup's position.
• The edges of the cup should again be swept with a finger to insure that no maternal
tissues are entrapped
Procedure
54. • Apply suction
• Suction pressure is measured in various units: 0.8 kg/cm2 of atmospheric pressure =
600 mmHg = 23.6 inches of Hg = 11.6 Ib/in
• Vacuum suction pressures of 500 to 600 mmH have been recommended during
traction, although pressures in excess of 450 mmHg are rarely necessary
• While lower suction pressures increase the risk of cup "pop-offs," pressures beyond
600 mmHg increase the risks of fetal scalp trauma and cerebral, cranial and scalp
hemorrhage
55. • Exert traction
• The absolute "safe" traction force for vacuum extraction is unknown. In 1962, one
group determined a total traction force of 17.6 kg was typically necessary to affect
delivery
• Traction is applied along the axis of the pelvic curve to guide the fetal vertex, led
by the flexion point, through the birth canal.
• Initially, the angle of traction is downward (toward the floor) the higher the
beginning station, the steeper the angle of downward traction required.
• The axis of traction is then extended upwards to a 45 degree angle to the floor as
the head emerges from the pelvis and crowns
59. Duration
• A maximum of two to three cup detachments, three sets of pulls for the descent
phase, three sets of pulls for the outlet extraction phase and/or a maximum total
vacuum application time of 15 to 30 minutes are commonly recommended, with most
authors advising lesser time limits
61. Advantage of ventouse over forceps
• It can be used in unrotated or malrotated head (OP, OT position). It helps in autorotation It is not a space-
occupying device like the forceps blades
• Traction force is less (10 kg) compared to forceps .It is comfortable and has lower rates of maternal trauma
and genital tract lacerations
• Analgesia need is less. Pudendal block with perineal infiltration is adequate but for forceps regional or
general anesthesia is often needed
• Reduced maternal pelvic floor injuries and is advocated as the instrument of first choice.
• Perineal injury (3rd and 4th degree tears) are less compared to forceps
• Postpartum maternal discomfort (pain) are less compared to forceps
• Easier to learn comparing to forceps
• Simplicity of use in delivery makes it convenient to the operator (suitable for trained midwives)
62. Advantage of forceps over ventouse
• In cases, where moderate traction is required, forceps will be more effective compared to ventouse
.Forceps operation can quickly expedite the delivery in case of fetal distress where ventouse will be
unsuitable as it takes longer time
• It is safer at any gestational age baby (even < 36 weeks). The fetal head remains inside the protective cage
• It can be employed in anterior face or in after-coming head of breech presentation, where ventouse is
contraindicated
• Lesser neonatal scalp trauma, retinal hemorrhage, jaundice or cephalhematoma compared to ventouse
• Higher rate of successful vaginal delivery as ventouse has got higher failure rates than forceps
• Cup detachment (Pop-off ) occurs when the vacuum is not maintained in ventouse. No such problems once
forceps blades are correctly applied
• Number of types of forceps (p. 651) are available for outlet, mid-cavity or rotational delivery. Traction
force is more (about 20 kg for a primary and about 13 kg in a multi)