1. The document discusses various instruments used in gynecology and obstetrics, providing brief descriptions of each instrument including its use.
2. Instruments described include Sims speculum, Cusco's speculum, Ayre's spatula, Hegar's dilator, needle holder, ovum holding forceps, and Pinard's fetal stethoscope.
3. The purpose of the document is to provide medical students with information about common instruments they may encounter during their final practical exam in obstetrics and gynecology.
This document discusses breech presentation, which occurs when a baby is positioned bottom or feet first in the uterus instead of head first. It defines the different types of breech positions and discusses risk factors, diagnosis, management options, and complications associated with vaginal breech delivery and cesarean section for breech babies. Management options include external cephalic version, vaginal delivery, or cesarean section depending on the specific situation. Risks and procedures for both vaginal delivery and cesarean section are outlined.
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
This document discusses polyhydramnios, or excessive amniotic fluid, during pregnancy. It defines polyhydramnios as an amniotic fluid index greater than 25 cm or a single vertical pocket over 8 cm. Common causes include fetal anomalies, placental tumors, multiple pregnancies, and maternal diabetes. Chronic polyhydramnios presents with abdominal swelling while acute cases are rarer and can be caused by twin-twin transfusion syndrome or large placental tumors. Ultrasound is used to diagnose and complications for both mother and baby must be monitored and managed.
Cardiotocography (CTG) is a technical method for recording the fetal heartbeat and uterine contractions during pregnancy using ultrasound and tocodynamometry. CTG involves using an electronic fetal monitor, commonly known as a cardiotocograph, to obtain a record of the fetal heart rate and uterine contractions. It was invented in the 1960s and refined to be more accurate. CTG is typically used in late pregnancy or labor to evaluate fetal well-being and identify any signs of hypoxia.
Amnioinfusion is a procedure where IV fluids are infused into the uterus during labor to relieve umbilical cord compression and alleviate fetal distress caused by prolonged variable decelerations associated with low amniotic fluid levels (oligohydramnios). Nurses assist physicians with amnioinfusion by helping with catheter placement, monitoring infusion rates and fetal heart tones, and discontinuing the procedure if complications arise like increasing uterine tone or signs of fetal compromise. They also carefully document details of the procedure.
Vacuum extraction is a method to assist in childbirth using suction from a cup placed on the baby's head to help with traction during contractions. There are different types of cups including metal, soft, and bird's cups. Vacuum extraction is indicated when forceps cannot be used and has advantages over forceps like less need for anesthesia and less compression force applied. Complications can include maternal lacerations and cervical injuries or fetal issues like cephalhematomas and scalp lacerations.
1. The document discusses various instruments used in gynecology and obstetrics, providing brief descriptions of each instrument including its use.
2. Instruments described include Sims speculum, Cusco's speculum, Ayre's spatula, Hegar's dilator, needle holder, ovum holding forceps, and Pinard's fetal stethoscope.
3. The purpose of the document is to provide medical students with information about common instruments they may encounter during their final practical exam in obstetrics and gynecology.
This document discusses breech presentation, which occurs when a baby is positioned bottom or feet first in the uterus instead of head first. It defines the different types of breech positions and discusses risk factors, diagnosis, management options, and complications associated with vaginal breech delivery and cesarean section for breech babies. Management options include external cephalic version, vaginal delivery, or cesarean section depending on the specific situation. Risks and procedures for both vaginal delivery and cesarean section are outlined.
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
This document discusses polyhydramnios, or excessive amniotic fluid, during pregnancy. It defines polyhydramnios as an amniotic fluid index greater than 25 cm or a single vertical pocket over 8 cm. Common causes include fetal anomalies, placental tumors, multiple pregnancies, and maternal diabetes. Chronic polyhydramnios presents with abdominal swelling while acute cases are rarer and can be caused by twin-twin transfusion syndrome or large placental tumors. Ultrasound is used to diagnose and complications for both mother and baby must be monitored and managed.
Cardiotocography (CTG) is a technical method for recording the fetal heartbeat and uterine contractions during pregnancy using ultrasound and tocodynamometry. CTG involves using an electronic fetal monitor, commonly known as a cardiotocograph, to obtain a record of the fetal heart rate and uterine contractions. It was invented in the 1960s and refined to be more accurate. CTG is typically used in late pregnancy or labor to evaluate fetal well-being and identify any signs of hypoxia.
Amnioinfusion is a procedure where IV fluids are infused into the uterus during labor to relieve umbilical cord compression and alleviate fetal distress caused by prolonged variable decelerations associated with low amniotic fluid levels (oligohydramnios). Nurses assist physicians with amnioinfusion by helping with catheter placement, monitoring infusion rates and fetal heart tones, and discontinuing the procedure if complications arise like increasing uterine tone or signs of fetal compromise. They also carefully document details of the procedure.
Vacuum extraction is a method to assist in childbirth using suction from a cup placed on the baby's head to help with traction during contractions. There are different types of cups including metal, soft, and bird's cups. Vacuum extraction is indicated when forceps cannot be used and has advantages over forceps like less need for anesthesia and less compression force applied. Complications can include maternal lacerations and cervical injuries or fetal issues like cephalhematomas and scalp lacerations.
Congenital malformations of the female genital tract can occur due to abnormalities during embryonic development. Uterine malformations in particular result from abnormal development of the Mullerian ducts. The most common types are caused by incomplete fusion of the ducts during embryogenesis. Uterine anomalies are often associated with vaginal maldevelopment and may cause issues like infertility, miscarriage, or obstructed labor. Diagnosis involves imaging tests like ultrasound, MRI, or hysteroscopy. Treatment depends on the type of abnormality but may involve surgical procedures to enable pregnancy or reduce risks.
Multiple pregnancy is used to describe the development of more than one fetus in the uterus at the same time. It is a high risk pregnancy. Careful supervision and proper monitoring is needed for prevention of further complications.
Uterine Rupture
Deepa Mishra
Assistant Professor (OBG)
Introduction
Uterine rupture is when the muscular wall of the uterus tears during pregnancy or childbirth
Symptoms while classically including increased pain, vaginal bleeding, or a change in contractions are not always present.
Disability or death of the mother or baby may result.
Definition
Uterine rupture is giving way of gravid uterus or dissolution in the continuity of uterine wall anytime after 28 weeks of gestation with or without expulsion of the fetus.
Incidence
Rates of uterine rupture during vaginal birth following one previous C-section, done by the typical technique, are estimated at 0.9%
Rates are greater among those who have had multiple prior C-sections or an atypical type of C-section.
In those who do have uterine scarring, the risk during a vaginal birth is about 1 per 12,000
Risk of death of the baby is about 6%
Etiology
Risk Factors
Previous cesarean section
Myomectomy
Dysfunctional labor
Labor augmentation by oxytocin or prostaglandins
High parity
First pregnancy- very rare
Types of uterine rupture
Complete Rupture
All the layers including peritoneum are torn and the uterine contents escape into the peritoneal cavity.
Usually results in death
Incomplete Rupture
Visceral peritoneum is intact and usually the fetus remains in the uterine cavity
Sign & Symptoms
Uterine dehiscence and abdominal pain and vaginal bleeding
Deterioration of fetal heart rate
Loss of fetal station on manual vaginal exam
Hypovolemic shock due to intrabdominal bleeding
Chest pain between the scapulae, pain during inspiration due to irritation of blood below the perineum
Cessation of uterine contractions
Palpation of fetus outside the uterus
Signs of abdominal pregnancy
Post term pregnancy
Diagnosis
Signs of obstructed labor with dehydration, exhaustion, tachycardia raised temperature tonic contraction , pathological retraction ring
Absent fetal heart sound
On PV hot, dry vagina with a large caput over the presenting part
Prevention
Early diagnosis and management of CPD mal presentation and obstructed labor
Proper selection of cases for vaginal delivery
Carefull monitoring of oxytocin infusion specially in multipara
Avoid intra uterine manipulation no version in single fetus
Instrumental delivery after cervical dilatation
Immediate CS in obstructed labor
Hospital delivery for high risk cases
ECV should be avoided during general anaesthesia
Careful manual removal of placenta
Treatment
Resuscitation with adequate hydration and blood transfusion
Laprotomy
Hysterectomy
Repair
Complication
Rupture uterus with haemorrhage, shock and sepsis
Fetal loss is high in spontaneous and traumatic rupture
Mortality is low in LSCS scar rupture
This document defines and classifies uterine abnormalities, or mullerian duct anomalies. It describes 7 classes of anomalies resulting from abnormal development of the mullerian ducts during embryogenesis. Class 1 involves complete or partial mullerian agenesis. Classes 2 through 5 involve various degrees of failure of the mullerian ducts to fully fuse, resulting in anomalies like a unicornuate, didelphys, bicornuate, or septate uterus. Class 6 is an arcuate uterus and Class 7 involves DES exposure in utero causing a T-shaped uterus. Symptoms may include pain or infertility. Diagnosis involves imaging tests. Treatment depends on symptoms but may involve surgery to correct the anomaly
Uterine rupture is a life-threatening condition where the wall of the uterus tears, potentially exposing the fetus and placenta to the mother's abdominal cavity. It most commonly occurs in women with a previous cesarean section scar. Signs include acute abdominal pain, fetal distress, and hemorrhage. Diagnosis is often made using ultrasound or MRI to detect tears in the uterine wall. Immediate exploratory laparotomy and cesarean delivery is usually required for treatment. Conservative uterine repair may be attempted for some cases but hysterectomy is often necessary due to severe hemorrhage. Prevention focuses on careful management of trial of labor for women with previous scars.
This document provides an overview of the placenta and its abnormalities. It begins with definitions of the placenta and discusses its embryological development. The structure and functions of the placenta are described, including its role in fetal circulation, maternal circulation, gas/nutrient exchange, and hormone production. Various placental abnormalities are outlined such as placenta previa. The structure and insertions of the umbilical cord are also reviewed.
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
This document summarizes several gynecological instruments including: Wrigley's forceps which are used to extend the head during delivery; Hegar's dilators which come in varying sizes to dilate the cervical canal prior to evacuation operations; Green Armytage forceps which are used for hemostasis and holding the abdominal sheath during C-sections; giant vulsellum forceps which provide a strong grip of fetal parts during destructive operations; multiple toothed vulsellum which grasp the anterior lip of the cervix during D&E operations; and Sim's speculum which allows inspection and cleaning of the cervix and vagina after delivery and during D&E operations.
Cardiotocography (CTG) involves continuous electronic monitoring of the fetal heart rate and uterine contractions. It is done externally via ultrasound transducers on the mother's abdomen or internally via an electrode attached to the fetal scalp. CTG is used to evaluate the fetal heart rate patterns including baseline rate, variability, accelerations, and decelerations which can indicate fetal well-being or distress. Abnormal patterns may necessitate changes to labor management or delivery.
nurses/doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.
This document provides an overview of abnormal labour, including definitions, causes, signs and symptoms, diagnosis, management, and specific types such as prolonged labour and maternal injuries. Abnormal labour is defined as labour that does not meet normal time limits and milestones. It can be caused by issues with uterine contractions, pelvic abnormalities, large babies, or psychological factors. Prolonged labour increases risks for both mother and baby. Management may include accelerating labour through drugs or proceeding with c-section if needed. Maternal injuries from labour include perineal tears, vaginal tears, cervical tears, and vulval hematoma, which require repair or drainage. The document also describes different types of abnormal uterine action.
Prolapse of the uterus refers to the downward displacement of the vagina and uterus. It can be congenital or acquired due to factors like childbirth, obesity, chronic coughing, and uterine fibroids. Symptoms include feeling something coming down in the vagina, backache, difficulty urinating, and incomplete bowel movements. Diagnosis involves physical examination in both dorsal and standing positions. Management includes preventative measures, conservative options like pessaries and exercises, and surgery if symptoms become worse.
The document discusses lactation management and breastfeeding. It provides objectives of lactation management including reviewing public health impacts and understanding physiology. It outlines recommendations for exclusive breastfeeding for six months and continued breastfeeding for at least one year. Common breastfeeding problems like low milk supply, mastitis and breast abscess are identified. The physiology of lactation including galactokinesis, lactogenesis and galactopoiesis is explained. Benefits of breastfeeding for both mother and infant are highlighted. Drugs to improve milk production and positions for breastfeeding are outlined. Contraindications and problems in breastfeeding are also discussed.
Instruments Gynecological/ obstetrics/ Compilation / Ziauddin HospitalDr. Darayus P. Gazder
The document describes various gynecological and obstetric instruments including forceps, dilators, speculums, catheters, and curettes. It provides the names of the instruments, images, and brief descriptions of their indications and uses in procedures like D&C, laparoscopy, delivery, tubal ligation and more. Common instruments mentioned are sponge holding forceps, ovum forceps, curette, volsellum, hegar's dilator, foley catheter, sims speculum, and suction curette. The document serves as a reference guide for gynecology and obstetrics medical professionals.
This document provides information on the stages of labor and management of the first stage of labor. It discusses the normal progression through the latent, active, and transition phases of the first stage. It also covers monitoring during labor including vital signs, contractions, and fetal heart rate. Active management of labor is described which includes interventions like amniotomy and oxytocin if progress is unsatisfactory. The nurse's role in caring for the woman in the first stage is also summarized.
This document discusses uterine malformations, which result from abnormal development of the Mullerian ducts in utero. It describes the 7 classes of uterine anomalies in the American Fertility Society classification system, including septate, bicornuate, and didelphys uteri. For each class, it covers defining features, incidence, diagnosis, associated reproductive risks like miscarriage and preterm birth, and potential treatment options like surgical resection. Complications from uterine anomalies can include abortion, placenta problems, and difficult labor.
This document discusses postpartum haemorrhage (PPH), defined as blood loss exceeding 500 ml following childbirth. It notes that PPH has various causes including an atonic uterus, trauma during delivery, retained placental tissues, and coagulation disorders. The primary types are those occurring within 24 hours of delivery. Management involves controlling blood loss, administering oxytocics, and may require interventions like uterine packing or hysterectomy in severe cases. Prevention strategies include active management of the third stage of labour and being prepared to treat PPH as a potential complication of childbirth.
1. Amniotic fluid is produced by the fetus urinating and respiratory secretions into the amniotic sac. It allows room for fetal growth and protects the fetus from trauma.
2. Abnormalities in amniotic fluid volume include oligohydramnios (low volume) and polyhydramnios (high volume). Oligohydramnios can cause fetal deformities and pulmonary hypoplasia while polyhydramnios increases risks of preterm labor and fetal malpresentation.
3. Causes of the abnormalities include fetal anomalies, maternal diabetes, and premature rupture of membranes. Management involves monitoring for complications, treating any underlying causes, and possibly inducing labor if fetal lung
Fetal surveillance in twin pregnancies is important due to increased risks of complications. Ultrasound is used to determine chorionicity and amnionicity, monitor growth, check for anomalies, and screen for conditions unique to twins like twin-twin transfusion syndrome. Dichorionic twins are monitored every 4 weeks after 16 weeks while monochorionic twins are monitored every 2 weeks due to higher risks. Complications require specialized management and timely intervention can help reduce poor outcomes for twins.
Instruments used in gynecology and obstetrics ~ young doctors research forumJonathan Bwalya
This document provides descriptions of various instruments used in gynecology and obstetrics, including their uses, indications, and brief descriptions of procedures. It summarizes over 20 different instruments such as forceps, dilators, speculums, retractors, and needles. For each instrument, it provides a brief description of what it is used for and how it is used in relevant procedures.
Gynecological and Obstetrics instrumentsRashmi Regmi
This document provides information on various gynecological and obstetric instruments including their indications. It describes forceps such as artery forceps, Allis' forceps, and Babcock's forceps. It also discusses dilators like Hegar's dilator and cervical dilators. Additionally, it mentions speculums including Cusco's speculum and Sims' speculum. The document provides details on 3 or more instruments and their uses in a variety of procedures.
Congenital malformations of the female genital tract can occur due to abnormalities during embryonic development. Uterine malformations in particular result from abnormal development of the Mullerian ducts. The most common types are caused by incomplete fusion of the ducts during embryogenesis. Uterine anomalies are often associated with vaginal maldevelopment and may cause issues like infertility, miscarriage, or obstructed labor. Diagnosis involves imaging tests like ultrasound, MRI, or hysteroscopy. Treatment depends on the type of abnormality but may involve surgical procedures to enable pregnancy or reduce risks.
Multiple pregnancy is used to describe the development of more than one fetus in the uterus at the same time. It is a high risk pregnancy. Careful supervision and proper monitoring is needed for prevention of further complications.
Uterine Rupture
Deepa Mishra
Assistant Professor (OBG)
Introduction
Uterine rupture is when the muscular wall of the uterus tears during pregnancy or childbirth
Symptoms while classically including increased pain, vaginal bleeding, or a change in contractions are not always present.
Disability or death of the mother or baby may result.
Definition
Uterine rupture is giving way of gravid uterus or dissolution in the continuity of uterine wall anytime after 28 weeks of gestation with or without expulsion of the fetus.
Incidence
Rates of uterine rupture during vaginal birth following one previous C-section, done by the typical technique, are estimated at 0.9%
Rates are greater among those who have had multiple prior C-sections or an atypical type of C-section.
In those who do have uterine scarring, the risk during a vaginal birth is about 1 per 12,000
Risk of death of the baby is about 6%
Etiology
Risk Factors
Previous cesarean section
Myomectomy
Dysfunctional labor
Labor augmentation by oxytocin or prostaglandins
High parity
First pregnancy- very rare
Types of uterine rupture
Complete Rupture
All the layers including peritoneum are torn and the uterine contents escape into the peritoneal cavity.
Usually results in death
Incomplete Rupture
Visceral peritoneum is intact and usually the fetus remains in the uterine cavity
Sign & Symptoms
Uterine dehiscence and abdominal pain and vaginal bleeding
Deterioration of fetal heart rate
Loss of fetal station on manual vaginal exam
Hypovolemic shock due to intrabdominal bleeding
Chest pain between the scapulae, pain during inspiration due to irritation of blood below the perineum
Cessation of uterine contractions
Palpation of fetus outside the uterus
Signs of abdominal pregnancy
Post term pregnancy
Diagnosis
Signs of obstructed labor with dehydration, exhaustion, tachycardia raised temperature tonic contraction , pathological retraction ring
Absent fetal heart sound
On PV hot, dry vagina with a large caput over the presenting part
Prevention
Early diagnosis and management of CPD mal presentation and obstructed labor
Proper selection of cases for vaginal delivery
Carefull monitoring of oxytocin infusion specially in multipara
Avoid intra uterine manipulation no version in single fetus
Instrumental delivery after cervical dilatation
Immediate CS in obstructed labor
Hospital delivery for high risk cases
ECV should be avoided during general anaesthesia
Careful manual removal of placenta
Treatment
Resuscitation with adequate hydration and blood transfusion
Laprotomy
Hysterectomy
Repair
Complication
Rupture uterus with haemorrhage, shock and sepsis
Fetal loss is high in spontaneous and traumatic rupture
Mortality is low in LSCS scar rupture
This document defines and classifies uterine abnormalities, or mullerian duct anomalies. It describes 7 classes of anomalies resulting from abnormal development of the mullerian ducts during embryogenesis. Class 1 involves complete or partial mullerian agenesis. Classes 2 through 5 involve various degrees of failure of the mullerian ducts to fully fuse, resulting in anomalies like a unicornuate, didelphys, bicornuate, or septate uterus. Class 6 is an arcuate uterus and Class 7 involves DES exposure in utero causing a T-shaped uterus. Symptoms may include pain or infertility. Diagnosis involves imaging tests. Treatment depends on symptoms but may involve surgery to correct the anomaly
Uterine rupture is a life-threatening condition where the wall of the uterus tears, potentially exposing the fetus and placenta to the mother's abdominal cavity. It most commonly occurs in women with a previous cesarean section scar. Signs include acute abdominal pain, fetal distress, and hemorrhage. Diagnosis is often made using ultrasound or MRI to detect tears in the uterine wall. Immediate exploratory laparotomy and cesarean delivery is usually required for treatment. Conservative uterine repair may be attempted for some cases but hysterectomy is often necessary due to severe hemorrhage. Prevention focuses on careful management of trial of labor for women with previous scars.
This document provides an overview of the placenta and its abnormalities. It begins with definitions of the placenta and discusses its embryological development. The structure and functions of the placenta are described, including its role in fetal circulation, maternal circulation, gas/nutrient exchange, and hormone production. Various placental abnormalities are outlined such as placenta previa. The structure and insertions of the umbilical cord are also reviewed.
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
This document summarizes several gynecological instruments including: Wrigley's forceps which are used to extend the head during delivery; Hegar's dilators which come in varying sizes to dilate the cervical canal prior to evacuation operations; Green Armytage forceps which are used for hemostasis and holding the abdominal sheath during C-sections; giant vulsellum forceps which provide a strong grip of fetal parts during destructive operations; multiple toothed vulsellum which grasp the anterior lip of the cervix during D&E operations; and Sim's speculum which allows inspection and cleaning of the cervix and vagina after delivery and during D&E operations.
Cardiotocography (CTG) involves continuous electronic monitoring of the fetal heart rate and uterine contractions. It is done externally via ultrasound transducers on the mother's abdomen or internally via an electrode attached to the fetal scalp. CTG is used to evaluate the fetal heart rate patterns including baseline rate, variability, accelerations, and decelerations which can indicate fetal well-being or distress. Abnormal patterns may necessitate changes to labor management or delivery.
nurses/doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.
This document provides an overview of abnormal labour, including definitions, causes, signs and symptoms, diagnosis, management, and specific types such as prolonged labour and maternal injuries. Abnormal labour is defined as labour that does not meet normal time limits and milestones. It can be caused by issues with uterine contractions, pelvic abnormalities, large babies, or psychological factors. Prolonged labour increases risks for both mother and baby. Management may include accelerating labour through drugs or proceeding with c-section if needed. Maternal injuries from labour include perineal tears, vaginal tears, cervical tears, and vulval hematoma, which require repair or drainage. The document also describes different types of abnormal uterine action.
Prolapse of the uterus refers to the downward displacement of the vagina and uterus. It can be congenital or acquired due to factors like childbirth, obesity, chronic coughing, and uterine fibroids. Symptoms include feeling something coming down in the vagina, backache, difficulty urinating, and incomplete bowel movements. Diagnosis involves physical examination in both dorsal and standing positions. Management includes preventative measures, conservative options like pessaries and exercises, and surgery if symptoms become worse.
The document discusses lactation management and breastfeeding. It provides objectives of lactation management including reviewing public health impacts and understanding physiology. It outlines recommendations for exclusive breastfeeding for six months and continued breastfeeding for at least one year. Common breastfeeding problems like low milk supply, mastitis and breast abscess are identified. The physiology of lactation including galactokinesis, lactogenesis and galactopoiesis is explained. Benefits of breastfeeding for both mother and infant are highlighted. Drugs to improve milk production and positions for breastfeeding are outlined. Contraindications and problems in breastfeeding are also discussed.
Instruments Gynecological/ obstetrics/ Compilation / Ziauddin HospitalDr. Darayus P. Gazder
The document describes various gynecological and obstetric instruments including forceps, dilators, speculums, catheters, and curettes. It provides the names of the instruments, images, and brief descriptions of their indications and uses in procedures like D&C, laparoscopy, delivery, tubal ligation and more. Common instruments mentioned are sponge holding forceps, ovum forceps, curette, volsellum, hegar's dilator, foley catheter, sims speculum, and suction curette. The document serves as a reference guide for gynecology and obstetrics medical professionals.
This document provides information on the stages of labor and management of the first stage of labor. It discusses the normal progression through the latent, active, and transition phases of the first stage. It also covers monitoring during labor including vital signs, contractions, and fetal heart rate. Active management of labor is described which includes interventions like amniotomy and oxytocin if progress is unsatisfactory. The nurse's role in caring for the woman in the first stage is also summarized.
This document discusses uterine malformations, which result from abnormal development of the Mullerian ducts in utero. It describes the 7 classes of uterine anomalies in the American Fertility Society classification system, including septate, bicornuate, and didelphys uteri. For each class, it covers defining features, incidence, diagnosis, associated reproductive risks like miscarriage and preterm birth, and potential treatment options like surgical resection. Complications from uterine anomalies can include abortion, placenta problems, and difficult labor.
This document discusses postpartum haemorrhage (PPH), defined as blood loss exceeding 500 ml following childbirth. It notes that PPH has various causes including an atonic uterus, trauma during delivery, retained placental tissues, and coagulation disorders. The primary types are those occurring within 24 hours of delivery. Management involves controlling blood loss, administering oxytocics, and may require interventions like uterine packing or hysterectomy in severe cases. Prevention strategies include active management of the third stage of labour and being prepared to treat PPH as a potential complication of childbirth.
1. Amniotic fluid is produced by the fetus urinating and respiratory secretions into the amniotic sac. It allows room for fetal growth and protects the fetus from trauma.
2. Abnormalities in amniotic fluid volume include oligohydramnios (low volume) and polyhydramnios (high volume). Oligohydramnios can cause fetal deformities and pulmonary hypoplasia while polyhydramnios increases risks of preterm labor and fetal malpresentation.
3. Causes of the abnormalities include fetal anomalies, maternal diabetes, and premature rupture of membranes. Management involves monitoring for complications, treating any underlying causes, and possibly inducing labor if fetal lung
Fetal surveillance in twin pregnancies is important due to increased risks of complications. Ultrasound is used to determine chorionicity and amnionicity, monitor growth, check for anomalies, and screen for conditions unique to twins like twin-twin transfusion syndrome. Dichorionic twins are monitored every 4 weeks after 16 weeks while monochorionic twins are monitored every 2 weeks due to higher risks. Complications require specialized management and timely intervention can help reduce poor outcomes for twins.
Instruments used in gynecology and obstetrics ~ young doctors research forumJonathan Bwalya
This document provides descriptions of various instruments used in gynecology and obstetrics, including their uses, indications, and brief descriptions of procedures. It summarizes over 20 different instruments such as forceps, dilators, speculums, retractors, and needles. For each instrument, it provides a brief description of what it is used for and how it is used in relevant procedures.
Gynecological and Obstetrics instrumentsRashmi Regmi
This document provides information on various gynecological and obstetric instruments including their indications. It describes forceps such as artery forceps, Allis' forceps, and Babcock's forceps. It also discusses dilators like Hegar's dilator and cervical dilators. Additionally, it mentions speculums including Cusco's speculum and Sims' speculum. The document provides details on 3 or more instruments and their uses in a variety of procedures.
This document provides descriptions and indications for use for various gynecological and obstetric instruments. It describes forceps such as artery forceps, Allis' forceps, and Babcock's forceps that are used for grasping tissues. It also describes dilators like Hegar's dilator and cervical dilators that are used to dilate the cervix. Other instruments described include speculums, retractors, scissors, catheters, and cannulas that each have specific uses during procedures such as examinations, surgeries, and testing.
Bivalve speculum (Cusco's speculum) The two-bladed, or bivalve, speculum is the most common type of instrument gynecologists use to examine the vagina and cervix. ...
Pediatric speculum. ...
Huffman speculum. ...
Pederson speculum. ...
Graves speculum.
This document describes various instruments used in obstetrics and gynecology. It discusses speculums such as Sim's speculum and Cusco's bivalve speculum used to visualize the vagina and cervix. Instruments for grasping the cervix like volsellum forceps and tenaculum are also described. Other instruments mentioned include dilators, curettes, biopsy forceps, retractors, hemostatic forceps, and needles and sutures used in procedures like hysterectomy and episiotomy. Forceps used for childbirth like obstetric forceps and instruments for clamping the umbilical cord are also summarized.
Secure Fit TPS - Trendelenburg Positioning SystemAliMed
SecureFit™ TPS Trendelenburg Positioning System delivers a simple, safe and secure way to position patients for Trendelenburg procedures. Offering a dramatically reduced set-up time, SecureFit is uniquely contoured to cradle the patient’s natural curvature, and the independent gel-encased cubes deliver maximum pressure redistribution and support, with minimal slipping.
Basics of laproscopic surgery..
by dr navdeep s kamboj presented at sgrdumsar amritsar.
topics covered--
1 basics of laparoscopy
2 lap cholecystectomy
3 lap appendixcectomy
pneumoperitonem
merits and demerits of laproscopy
ligasure
endoscopy,
laparoscopic instruments
This document provides an overview of an obstetric ultrasound course for midwifery students. The course covers topics such as the basics of ultrasound, indications for obstetric ultrasound, first, second and third trimester ultrasound, complications of early pregnancy, biophysical profile, placenta, fetal anomalies, and more. It includes lecture content on defining ultrasound, how it works, its uses and safety. Content also covers transabdominal and transvaginal ultrasound techniques. The goal is for students to understand obstetric ultrasound and be able to perform scans to assess fetal health and development.
The document discusses instrumental vaginal deliveries such as forceps delivery and vacuum extraction. It notes that these procedures are becoming less common due to the safety of c-sections and higher expectations. Risks to both mother and baby are outlined. Safe practices including indications, prerequisites, and avoiding errors are presented to minimize risks when these procedures are necessary. The overall goal for any delivery is a healthy outcome for both mother and baby.
This document describes the contents of a lower segmental caesarean section tray. It contains various forceps, clamps, retractors, and scissors needed to deliver a baby through an incision in the lower uterine segment. Key items include Green Armytage forceps for grasping the uterine incision edges, umbilical cord cutting scissors with curved blades, and disposable plastic cord clamps. The tray also contains oxytocin and ergometrine injections to induce uterine contractions and control bleeding.
This document describes the contents of a lower segmental caesarean section tray. It contains various forceps, clamps, retractors, and scissors needed to deliver a baby through an incision in the lower uterine segment. Key items include Green Armytage forceps for grasping the uterine incision edges, umbilical cord cutting scissors with curved blades, and disposable plastic cord clamps. The tray also contains oxytocin and ergometrine injections to induce uterine contractions and control bleeding.
The partograph is a composite graphical record of key maternal and fetal data entered against time on a single sheet of paper. It provides an accurate record of labor progress so that any delays or deviations from normal can be quickly detected and treated. The WHO model partograph is based on principles like active labor beginning at 3 cm dilation and not lasting longer than 8 hours, with a rate of dilation of at least 1 cm/hour and a 4 hour lag time before intervention is needed. While it allows labor to be monitored at a glance, the partograph requires skilled healthcare workers for proper use and interpretation.
Lap. Tapp Made Easy Using The Innovative Tumescent TechniqueGeorgeVictor24
This document discusses using a tumescent technique for laparoscopic inguinal hernia repair. The tumescent technique involves injecting a dilute local anesthetic solution into the subcutaneous tissue to create a bulge and separate vital structures from the parietal peritoneum. This allows for a bloodless operative field and clear anatomy during laparoscopic hernia repair. The document presents the learning objectives and techniques for laparoscopic hernia repair using tumescent injection. It summarizes the patient outcomes when using this technique, including less pain and early discharge from the hospital.
This document discusses complications that can occur during hysteroscopic procedures. It begins by defining various complications such as perforation, bleeding, fluid overload, and infection. It then discusses incidence rates and risk factors for complications. The remainder of the document provides details on specific complications, how to recognize them, and strategies for prevention and management. It emphasizes the importance of proper patient positioning, techniques such as gradual dilation to avoid false passages, and using distension media carefully to prevent fluid overload.
This document discusses the partograph, which is a composite graphical record used to monitor labor. It is used to assess the progress of normal and abnormal labor and the fetal response. The partograph allows providers to visualize cervical dilation over time and identify issues early. It includes components like maternal information, fetal well-being, labor progress, medications, and maternal condition. Using a partograph has benefits like early detection of problems, prevention of prolonged labor, and improved outcomes for mothers and babies.
This document summarizes variations that can occur in maxillary permanent molars, including paramolar tubercles, fusion between molars, and variations in cusp morphology and root anatomy. Paramolar tubercles are additional cusps that can occur on the buccal surface and range in prevalence from 0-4.7% depending on the molar. Fusion can result from the union of tooth germs and cause complete or incomplete joining of molars. A study in India found that 32.6% of maxillary first molars had 5 cusps while 67.08% had 4 cusps and 0.32% had 3 cusps. Variations in root anatomy include maxillary molars
Laparoscopic sterilization was the first popular minimal access surgical procedure ever performed. Laparoscopic sterilization is very straightforward procedure. Worldwide laparoscopic sterilization is now the most commonly applied method for family planning
This document discusses face masks, airways, laryngoscopes, endotracheal tubes, and extubation. Face masks are used for non-intubated ventilation and come in different sizes. Airways are inserted to prevent the tongue from falling back. Laryngoscopes are used to visualize the glottis and facilitate intubation, and come in different blade shapes like Macintosh and Miller. Endotracheal tubes are inserted into the trachea and come in different types and sizes. Extubation should be performed when respiration is adequate and during inspiration.
This document discusses facial palsy and its management. It begins with an overview of grading scales used to assess recovery from facial nerve paralysis. It then describes various clinical tests that can localize facial nerve injuries, including taste tests, salivation tests, tearing tests, and blink reflex tests. Surgical management options for long-standing facial palsy are discussed, including nerve grafts, hypoglossal-facial nerve anastomoses, cross-facial nerve grafts, and the babysitter technique. Static and dynamic reanimation procedures are also summarized, such as sling plasties, temporalis muscle transfers, and free muscle transfers. The document concludes with a case example of Bell's pals
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
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
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
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.
1. Instruments In Obs/Gyn - Dr Damle Hemant
Instruments In Gynecology and Obstetrics
Dr Damle Hemant S.
(M.D.)
Professor & Head Dept. of Obstetrics & Gynecology
Smt. Kashibai Navale Medical College Pune.
file:///E|/CDInstruments/Dec2009Updates/New1.htm [08/12/2009 04:41:11 AM]
2. Preface Instrument in Obs/Gyn - Dr Damle Hemant
Preface
Instrument table in practical examination is an important table.
If answered correctly student can score good marks. It also boost their confidence .
Usually a limited no of instruments are kept for Final MBBS practical examination
in the subject of Obstetrics and Gynecology.
In this booklet you will find list of instruments and their details.
This booklet is accompanied with the CD which gives the photographs
and other information about the instruments.
The information is deliberately kept brief so that student can easily revise
and remember the instruments before the practical exam.
.
Dr Hemant S. Damle
Gudipadwa
27 March 2009.
file:///E|/DrDamleHemant/Preface.htm [4/22/2006 8:54:27 PM]
3. Index Instruments - Dr Damle Hemant
Instruments in Gynecology and Obstetrics
Dr Damle Hemant S.
Index
Allis' Forceps Artery Forceps
Ayre's Spatula Babcock's Forceps
Band Applicator for Lap TL Cusco's Speculum
Doyens Retractor. Episiotomy Scissors.
Foleys Catheter Green Armytage Forceps
Hegars Dilator Kocher's Forceps
Karman's Syringe ( Menstrual
Regulation),
Leech Wilkinson Cannula
Needle Holder Ovum Holding Forceps
Purandare's Dilator Pinard's Fetal Stethoscope
Rubins Cannula Sims' Anterior Vaginal Wall Retractor.
Sims' Speculum Sponge Holder
Suction Curette, Shirodkars Circalage Needle.
Suture Material Trocar and Cannula
Umbilical cord Clamp & Scissors UterineCurette
Uterine sound Vulsellum Tenaculum
Vaccum Extractor.(Vantouse). Varies Needle
Wrigley's Forceps,
file:///E|/DrDamleHemant/Index.htm [4/22/2006 8:54:27 PM]
4. AllisForceps Inst. In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Allis' Forceps
This instrument is used for grasping tough structures like Rectus sheath or fascia in operations like tubectomy,LSCS
,abdominal hysterectomy.
file:///E|/DrDamleHemant/allisforceps.htm [4/22/2006 8:54:28 PM]
5. Artery Forceps Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Artery Forceps
This is a hemostat. Used for clamping bleeding vessels. It is also used for grasping tissue at the time of operation.
( Opening and closing peritoneum) . It is also used to hold stay sutures. It comes in two shapes straight and curved.
Usually straight is used for rough work like stay and curved is used as hemostat.
file:///E|/DrDamleHemant/artery_forceps.htm [4/22/2006 8:54:29 PM]
6. Ayers Spatchula Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Ayre's Spatula
Use for taking Pap Smear for screening of carcinoma cervix.
Made of wood so that cells can adhere to its porous surface.
The long end is inserted into cervical canal and rotated in 360 degrees.
The exfoliated cells obtained are smeared on glass slide and fixed in Koplicks jar
which contains ether and alcohol in equal amount. or by hair spray.
The other broad end is used for obtaining cells from lateral vagina for knowing the hormonal status.
file:///E|/DrDamleHemant/AyersSp.htm [4/22/2006 8:54:29 PM]
7. Babcock's Forceps Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Babcock's Forceps
This instrument is used for grasping tubular structures like fallopian tube in tubectomy in modified Pomeroy's operation ,
ureter ,appendix etc. The tip is atraumatic as there are no sharp tooth.
file:///E|/DrDamleHemant/babcocks_forceps__inst_in_obs.htm [4/22/2006 8:54:30 PM]
8. Band Applicator for Lap TL Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Band Applicator for Lap TL
file:///E|/DrDamleHemant/band_applicator_for_lap_tl.htm (1 of 2) [4/22/2006 8:54:31 PM]
9. Band Applicator for Lap TL Inst In Obs/Gyn - Dr Damle Hemant
This instrument is used for applying silastic bands to fallopian tubes in laparoscopic tubal ligation. The tube is
identified and grasped in the ampullary region by opening the prongs. The prongs are pulled inside the sheath
and the loaded ring is then pushed over the tube. The prongs are then released. The part of the tube above the
band looks blanched.
The bands are loaded just prior to grasping the tube.
file:///E|/DrDamleHemant/band_applicator_for_lap_tl.htm (2 of 2) [4/22/2006 8:54:31 PM]
10. Cuscos Speculum Dr Damle Hemant
<<<< Back To Index
Cusco's Speculum
Self retaining double bladed vaginal speculum.
Used in OPD for routine examination.
Because of limited opening only few procedures like taking of Pap smear ,
insertion and removal of Copper T can be done.
file:///E|/DrDamleHemant/CuscosSpeculum.htm [4/22/2006 8:54:36 PM]
11. Doyens Retractor Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Doyen's Retractor
This instrument is used for retracting bladder during abdominal operations like LSCS , abdominal hysterectomy , laparotomy.
The smooth edge and the curvature retracts the bladder and protects it during surgery.
Right Angle Retractor used for Tubectomy.
Deaver's Retractor for retraction of deep structures.
file:///E|/DrDamleHemant/doyens_retractor.htm (1 of 2) [4/22/2006 8:54:37 PM]
12. Doyens Retractor Inst In Obs/Gyn - Dr Damle Hemant
Deaver's Retractor for retraction of deep structures.
file:///E|/DrDamleHemant/doyens_retractor.htm (2 of 2) [4/22/2006 8:54:37 PM]
13. Episiotomy Scissors Inst In obs/Gyn - Dr damle Hemant
<<<< Back To Index
Episiotomy Scissors.
This is used for giving episiotomy. Episiotomy is given in primi ( rigid perineum) , before forceps or vacuum , in breech delivery ,in preterm
delivery..
Episiotomy is usually given under local anesthesia ( 1% Xylocain) at the time of crowning of head. The sharp blade of the instrument is
inserted in the vagina protecting fetus by two fingers of the doctor. The cut is given medio laterally ( Midline or Lateral episiotomy is usually
not given)
The episiotomy is sutured in 3 layers with no 0 ( one zero) chromic catgut. The first layer is vagina starting with the apex. The second layer is
perineal muscles and the third layer is skin.
The episiotomy can extend if proper perineal support is not given. Extension to anus is seen in median episiotomy.
file:///E|/DrDamleHemant/episiotomy_scissors.htm [4/22/2006 8:54:38 PM]
14. Foleys Catheter Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Foleys Catheter
This is a self retaining catheter most commonly used for drainage of the urinary bladder after surgery.
It is used in operations like Abdominal , Vaginal Hysterectomy , Wertheim's Hysterectomy, Repair of
Vesico vaginal fistula.
It is also used for second trimester MTP for extra amniotic instillation of ethacredyl lactate .
It is also used for diagnosis of incompetent cervix and for sono salpingo graphy.
It has a bulb below the tip. This can be inflated by normal saline. It has two channels. One for inflating
bulb and has a valve
The other channel is for drainage of urine to which urobag is attached. No 14 or 16 are used in adult. No
8 for sono salpingo graphy.
file:///E|/DrDamleHemant/foleys_catheter.htm [4/22/2006 8:54:38 PM]
15. Green Armytage Forceps Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Green Armytage Forceps
Tip of the forceps
This forceps is used as a hemostat in caesarean operation. As the tips are broad wide area can be
compressed.
In LSCS the cut uterine edges bleed . This forceps is applied to the two angles and lower and upper edge of
the incision.
The common indications for LSCS are fetal distress in first stage, CPD , abnormal presentations like
transverse lie , brow , breech in primi ,previous two scars on the uterus.
file:///E|/DrDamleHemant/green_armytage_forceps.htm [4/22/2006 8:54:39 PM]
16. Hegars Dilator
<<<< Back To Index
Hegar's Dilator
Its a long rod like instrument with gentle curve and tapering tip. It is used for dilatation of the cervix in procedures
like
D&C , D& E , Fothergills operation , Hysteroscopy , Cervical Stenosis , Primary dysmenorrhoea.
It can cause perforation if too much force is used.
The dilators are numberd as per outer diameter ( No 8 means outer diameter of 8 mm) For D&C dilation up to 8 is
done
For MTP dilatation up to 12 may be required. Very large dilatation can cause cervical incompetence.
file:///E|/DrDamleHemant/HegarsDilator.htm [4/22/2006 8:54:39 PM]
17. Kochers Forceps Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Kocher's Forceps ( Clamp)
This instrument is used for holding pedicles in hysterectomy. The tips of the blades have teeth so that the tissue does not slip.
The blades can either be straight or curved. This instrument is used in hysterectomy to clamp pedicles which are then transfixed.
It is also used for salpingectomy in ectopic or oophorectomy in ovarian mass. This can also be used for clamping umbilical cord of
new born at the time of delivery or for artificial low rupture of membranes ( ARM).
Tip of the clamp showing teeth.
file:///E|/DrDamleHemant/KochersForceps.htm [4/22/2006 8:54:45 PM]
18. Karman Syringe Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Karman's Syringe ( Menstrual Regulation)
This syringe is used for Menstrual Regulation and endometrial aspiration. The capacity is 50 ml. The tip has a rubber
attachment with valve.
The piston when withdrawn can be locked. It creates negative suction. To the rubber attachment at the tip, plastic
cannula is attached and is inserted in uterine cavity. The valve is released and with negative pressure contents of the
uterine cavity are sucked. This should be repeated till the cavity is empty. Complication of the procedure is incomplete
evacuation because of limited suction pressure.
file:///E|/DrDamleHemant/karman.htm [4/22/2006 8:54:45 PM]
19. Rubins Cannula Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Rubin's Cannula
Tip Of cannula
This cannula is used for tubal patency test for infertility like HSG ( Hystero salpingo graphy ) or Chromo perturbation in
laparoscopy. In HSG radio opaque iodine ( Urographin) is used ( it is colorless to naked eye but on X Ray is seen as opaque
white)For Laparoscopy Methylene Blue dye is injected through the cannula. This cannula has a rubber guard which needs
adjustment. It prevents backward leak of the dye. These tests are also performed after tuboplasty .
Leech Wilkinson's Cannula
file:///E|/DrDamleHemant/rubins_cannula.htm (1 of 2) [4/22/2006 8:54:46 PM]
20. Rubins Cannula Inst In Obs/Gyn - Dr Damle Hemant
Tip Of The Cannula
This cannula is also used for tubal patency . It is straight instrument with conical tip. This cone is screwed into the
cervix. Then dye is injected.
Combined Uterine manipulator and cannula for laparoscopy
file:///E|/DrDamleHemant/rubins_cannula.htm (2 of 2) [4/22/2006 8:54:46 PM]
21. Needle Holder Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Needle Holder
This instrument is used for grasping needle at the time of suturing. The inner surface of tip has serrations
and a small grove for firm grasp of the curved needle. The box joint is placed very close to tip to give
adequate pressure because of the lever effect.
file:///E|/DrDamleHemant/needle_holder.htm [4/22/2006 8:54:47 PM]
22. Ovum Holding Forceps Inst In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Ovum Holding Forceps
Tip of Ovum Forceps.
This instrument is used for removing the products of conception in inevitable , incomplete abortion and in MTP operations.
The tip of this instrument is rounded cup like to avoid perforation and to hold large tissue. This instrument has no catch . This is to
avoid perforation of wall.
file:///E|/DrDamleHemant/ovum_holding_forceps.htm [4/22/2006 8:54:52 PM]
23. Purandares Dilator Inst in Ob Gy Dr Damle Hemant
<<<< Back To Index
Purandare's Dilator
This cervical dilator has a guard and long tapering end. The guard helps in preventing insertion beyond that length and
protect against perforation.
Here in the picture it is numbered 2,3,4,5 representing diameter in mm from the tip to the guard.
file:///E|/DrDamleHemant/PurandaresDilator.htm [4/22/2006 8:54:53 PM]
24. Pinard Instruments in Obe/Gyn Dr Damle Hemant.
<<<< Back To Index
Pinard's Fetal Stethoscope.
This is used for auscultation of fetal heart. The tapering rim is applied to ear and the other side to
mothers abdomen.
With other instruments available for auscultation of fetal heart this is now rarely used.
file:///E|/DrDamleHemant/pinard.htm [4/22/2006 8:54:53 PM]
25. Anterior Vaginal Wall Retractor Dr Damle Hemant Dr Damle
<<<< Back To Index
Sims' Anterior Vaginal Wall Retractor.
This instrument is used with Sim's Speculum Its a long instrument with blunt loops at
both the ends making an angle for easy visualization of cervix and vagina. especially
useful in case of cystocele.
file:///E|/DrDamleHemant/AntVagRetractor.htm [4/22/2006 8:54:53 PM]
26. Sims Speculum Dr Damle Hemant
<<<< Back To Index
Sims' Speculum
Sims Speculum is used for inspection of vagina and cervix in the OPD. It retracts posterior
vaginal wall.
For complete visualization anterior vaginal wall retractor must be used.
Use on Gyn OPD for following procedures : Taking Pap Smear , Insertion and removal of
Copper T , Colposcopy ,Taking swabs
for microscopic examination in suspected infections. Hyseterosalpingography (HSG)
Use in Gyne Operations : D&C , Cervix Biopsy , Vaginal Hysterectomy , Fothergills
Operation, Repair of Vesico vaginal fistula
Hysteroscopy.
Use in Obs : For inspection ( Bluish discoloration in early pregnancy, local cause for
threatened abortion, local cause in APH), First trimester MTP by suction curettage . In
file:///E|/DrDamleHemant/SimsSpeculum.htm (1 of 2) [4/22/2006 8:54:58 PM]
27. Sims Speculum Dr Damle Hemant
second trimester MTP by Ethacredyl Lactate. Os thightening or cervical encircalage ,
Removal of os thightening stitch at the onset of labor or at 38 wks. Inspection for suspected
rupture of membranes.
After forceps delivery to trace for cervical tears.
Advantage : Wide area for inspection. Instrumentation is easy
Disadvantage : Needs assistant (Not self retaining) , Must bring pt to edge of the table.
file:///E|/DrDamleHemant/SimsSpeculum.htm (2 of 2) [4/22/2006 8:54:58 PM]
28. Sponge Holder Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Sponge Holder / Sponge holding forceps.
This instrument is used for holding sponge or a gauze piece for painting the area before operation.
This is also used for tissue dissection when used as sponge on holder .
This also used for grasping the cervix is obstetrics in Os tightening operation. Second trimester MTP ( to hold the cervix before
insertion of Foleys catheter). In exploring cervix after forceps delivery ( three sponge holding forceps are used). In LSCS this
can be used instead of Green Armytage for clamping the bleeding edges of uterine incision)
file:///E|/DrDamleHemant/sponge_holder.htm [4/22/2006 8:54:58 PM]
29. Suction Curette Inst. In Obs/Gyn dr Damle Hemant
<<<< Back To Index
Suction Curette
Tip of the suction curette
This instrument is used for first trimester MTP, suction of vesicular mole. It is numbered as per outer diameter. The size of the
cannula selected is equal to no of weeks of pregnancy. The tip is blunt ( to prevent perforation ) below the tip are two sharp openings
for suction and curetting the cavity. Usually suction force of 60 mm Hg is applied. Rotational and to-fro movements are done to
empty the cavity. Grating sensation and gripping of the cannula indicates the procedure is complete.
file:///E|/DrDamleHemant/suction_curette.htm [4/22/2006 8:55:04 PM]
30. Shirodkars Cerclage Needle Inst. In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Shirodkars Cerclage Needle.
This is specially designed needle for putting stitch around the cervix. The needle is inserted around the cervix through the
opening made in vagina .
The suture material ( Merciline tape) is threaded on the eye present at the tip and withdrawn. Another needle with curvature in
reverse direction is used for other side. The knot is placed post. Vagina is closed.
file:///E|/DrDamleHemant/shirodkars_circalage_needle.htm [4/22/2006 8:55:04 PM]
31. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Suture Material and Blades
Chromic catgut ( One Zero ) on round body needle.
This is an absorbable suture manufactured from gut of large animals. The chromic catgut is brown in color and is treated with chemicals to
delay the absorption up to 7 days. This suture material is used most commonly for suturing of episiotomy, perineal tares, tubal ligation with
modified Pomeroy's Method, for closing peritoneum in LSCS and hysterectomy.
Plain Catgut
file:///E|/DrDamleHemant/suture_material.htm (1 of 15) [4/22/2006 8:55:06 PM]
32. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
This is a rapidly absorbable suture (absorbed in 7 days ) , yellow in color , used sometimes for approximation of sub cutaneous fat.
Vicryl ( One Zero on Round Body)
file:///E|/DrDamleHemant/suture_material.htm (2 of 15) [4/22/2006 8:55:06 PM]
33. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
This is a synthetic delayed absorbable suture colored violet. This get absorbed after 90 days. It causes less tissue reaction
than catgut and maintains strength for longer time than catgut.
It is used for suturing uterus in LSCS and tying pedicals in Hysterectomy.
Vicryl ( Number One on Round Body Needle)
file:///E|/DrDamleHemant/suture_material.htm (3 of 15) [4/22/2006 8:55:06 PM]
34. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
This is thicker than no zero and hence has more strength. Used for thick pedicals in hysterectomy.
Note the code no NW2347
Ethilon (No One on Curve cutting needle)
file:///E|/DrDamleHemant/suture_material.htm (4 of 15) [4/22/2006 8:55:06 PM]
35. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
The ethilon is a synthetic non absorbable suture used for rectus sheath and skin.( cutting needle is used for tough structures)
and ethilon no 1 on round body needle is used for cervical circlage.
Ethilon (No One on Round body needle)
file:///E|/DrDamleHemant/suture_material.htm (5 of 15) [4/22/2006 8:55:06 PM]
36. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Skin stapler and staple
file:///E|/DrDamleHemant/suture_material.htm (6 of 15) [4/22/2006 8:55:06 PM]
37. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Prolene is synthetic non absorbable suture used mainly for repair of hernias .
file:///E|/DrDamleHemant/suture_material.htm (7 of 15) [4/22/2006 8:55:06 PM]
38. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Linen
file:///E|/DrDamleHemant/suture_material.htm (8 of 15) [4/22/2006 8:55:06 PM]
39. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
The linen is natural non absorbable suture . Numbered as 40 , 60 ( No 60 is thinner) used for tying bleeders and vessels.
Black silk
file:///E|/DrDamleHemant/suture_material.htm (9 of 15) [4/22/2006 8:55:06 PM]
40. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Mersiline Tape used for Shirodkar's slings operation.
file:///E|/DrDamleHemant/suture_material.htm (10 of 15) [4/22/2006 8:55:06 PM]
41. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Stapler Removal
Rapid Vicryl
This is a new material white in color , synthetic, gets absorbed rapidly than Vicryl and is used for episiotomy
file:///E|/DrDamleHemant/suture_material.htm (11 of 15) [4/22/2006 8:55:06 PM]
42. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Safil
This material is similar to vicryl
file:///E|/DrDamleHemant/suture_material.htm (12 of 15) [4/22/2006 8:55:06 PM]
43. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Safil Quick
This a new material white in color , synthetic, gets absorbed rapidly than Safil and is used for episiotomy
MONOSYN
This is synthetic monofilament absorbable suture used for sub cut stitches.
file:///E|/DrDamleHemant/suture_material.htm (13 of 15) [4/22/2006 8:55:06 PM]
44. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
Surgical Blades
Blade Handles come in two sizes No 4 for big blades.
No 20 Blade used for Skin Incision in LSCS , Laparotomy etc.
No 15 Blade for fine incision
file:///E|/DrDamleHemant/suture_material.htm (14 of 15) [4/22/2006 8:55:06 PM]
45. Suture Material Inst in Obs/Gyn - Dr Damle Hemant
No 11 Blade for Stab Incision like drainage of abscess or putting trocar
No 10 Blade for small incisions.
file:///E|/DrDamleHemant/suture_material.htm (15 of 15) [4/22/2006 8:55:06 PM]
46. Trocar and Cannula Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Trocar and Cannula
Trocar is put in to the cannula and then inserted into abdominal cavity for laparoscopy. It is also called port ( port of entry to telescope and other instruments.) It
is numbered as per outer diameter. 10 mm is used for operative telescope, 7 mm is used for Band Applicator for Tubal Ligation, 5mm is used for other hand
instruments like grasper etc. A Reducer sleeve is available to use large size port for small instrument.
It has a trumpet valve to prevent gas leak. On one side there is opening for connecting it to gas ( CO2 or Air).
file:///E|/DrDamleHemant/trocar_and_cannula.htm [4/22/2006 8:55:07 PM]
47. Cord Clamp Inst. In Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Cord Clamp
file:///C:/Documents%20and%20Settings/Administrator/My%20Documents/My%20Webs/cord_clamp.htm [4/22/2006 8:55:07 PM]
48. Umbilical Cord Cutting Scissors Inst In Obs/Gyn Dr Damle Hemant
<<<< Back To Index
Umbilical Cord Cutting Scissors
Use for cutting umbilical cord after delivery.
file:///E|/DrDamleHemant/umbilical_cord_cutting_scissors.htm [4/22/2006 8:55:08 PM]
49. Uterine Curate Inst In Ob Gyn - Dr Damle Hemant
<<<< Back To Index
Uterine Curette
Use for scraping endometrial cavity to obtain sample for histopathology. The tip is angled by about 15 degrees for easy
scraping.
The tip comes in two shapes. Sharp and Blunt. Sharp curate is used in gynecology and blunt in pregnancy check
curettage.
Diagnostic D&C is done commonly for Menorrhagia, Endometrial Carcinoma, Infertility ,Tuberculosis of endometrium .
It also has secondary beneficial advantage of reducing the bleeding in menorrhagia.
file:///E|/DrDamleHemant/uterinecurate.htm [4/22/2006 8:55:08 PM]
50. Uterine Sound Dr Damle
<<<< Back To Index
Uterine sound
Its a long instrument with blunt tip ( To avoid perforation) About 5 cms from the tip its bend to make angle of 30 degrees.
It has marking on it for measurements. ( Bladder sound has no markings )
The angle helps to negotiate curvature of the uterus (Anteflexion). It is used for measuring uterocervical length , length of the
cervix (for diagnosing supra vaginal elongation of the cervix). To feel for any pathology inside the cavity like fibroid ( Sub mucus,
polyp) Congenital anomalies like septa or bicornuate ut. Adhesions or synachae. To feel for the misplaced IUCD.
It can create false passage or perforation especially in soft uterus in pregnancy.
Bladder Sound
It is long instrument with gentle curve ( not angled like uterine sound) and has no markings on it.
It is used to define extension of bladder cystocele and vaginal hysterectomy.
Tip Of Bladder Sound
file:///E|/DrDamleHemant/uteriesound.htm (1 of 2) [4/22/2006 8:55:10 PM]
51. Uterine Sound Dr Damle
file:///E|/DrDamleHemant/uteriesound.htm (2 of 2) [4/22/2006 8:55:10 PM]
52. Vulsellum
<<<< Back To Index
Vulsellum
This instrument is used for grasping the cervix ( Usually anterior lip of the cervix is
grasped)
Its a long instrument with gentle curve so that the line of vision is not obstructed. The
tip of the blades have 3-4 teeth to hold and steady the cervix in procedures like Insertion
of IUCD , Cx Biopsy D&C, First trimester MTP with Suction Evacuation. Cx Biopsy ,
Fothergills operation, Vaginal Hysterectomy
Posterior lip of the cervix is grasped for post. colpotomy .
Since the teeth are sharp it is not used in pregnancy as it may cause cervical tares and
lacerations. Instead sponge holding forceps is used to grasp the cervix.
Tenaculum
file:///E|/DrDamleHemant/vulsellum.htm (1 of 2) [4/22/2006 8:55:10 PM]
53. Vulsellum
This instrument is straight instrument and has only single bite for grasping the cervix.
It is used for Hystero salpingo graphy , Hysteroscopy . Laparoscopic chromo
pertubation.
Tip of Tenaculum
file:///E|/DrDamleHemant/vulsellum.htm (2 of 2) [4/22/2006 8:55:10 PM]
54. Vaccum Extractor Inst In Obs/ Gyn - Dr Damle Hemant
<<<< Back To Index
Vaccum Extractor.(Vantouse).
Metal Cup
file:///E|/DrDamleHemant/vaccum_extractor.htm (1 of 2) [4/22/2006 8:55:16 PM]
55. Vaccum Extractor Inst In Obs/ Gyn - Dr Damle Hemant
Sialastic Cup
Sialastic Cup
Alternative to forceps. Causes less trauma to mother and fetus. Pre requisites almost same.
Available in two forms : Metal cup and sialistic cup. Can be used when rotation is not complete.
Produces artificial caput called chignon. Not to be used in pre term delivery.
file:///E|/DrDamleHemant/vaccum_extractor.htm (2 of 2) [4/22/2006 8:55:16 PM]
56. Varies Needle Inst In Obs & Gyn - Dr Damle Hemant
<<<< Back To Index
Varies Needle
This needle is used for creating pneumo peritoneum ( Putting Air or CO2 in the peritoneal cavity) for laparoscopy.. The tip of the
needle is special. The inner round tip retracts when meets the resistance ( Like entering skin and Rectus sheath) and allows outer sharp
bevel to pierce. After entering the peritoneal cavity (When the resistance is lost) the inner round tip comes out with spring action. This
prevents damage to inner structures
Before inserting it is grasped like a dart at its base. The test for successful entry into peritoneal cavity is
1 Drop of saline gets sucked.
2 Nothing comes after aspiration with syringe
file:///E|/DrDamleHemant/varies__needle.htm [4/22/2006 8:55:17 PM]
57. Wrigley's Forceps Inst in Obs/Gyn - Dr Damle Hemant
<<<< Back To Index
Wrigley's Forceps
Obstetric forceps for out let forceps delivery. It has pelvic curve. Parts of the forceps are blades ( which has windows or fenestrate
for firm grip of the head) ,Shank , Lock( English lock for Wriglys forceps) , Handle.
Simson's Short forceps is straight forceps with only cephalic curve and no pelvic curve.
Some of the Pre requisite for forceps application : Dilatation of the cervix must be full (10cm) Station of Vertex at plus 2 or plus 3
(for outlet forceps),membranes should be ruptured , pelvis must be adequate. Uterine contractions must be good. Rotation of
vertex near complete. Local anesthesia and episiotomy must be given. >
file:///E|/DrDamleHemant/wrigley.htm [4/22/2006 8:55:28 PM]
58. Instruments In Obs/Gyn - Dr Damle Hemant
Acknowlegements
I wish to thank all my colleagues from the dept of obstetrics and gynecology at
SKN Medical College Pune
for their help in creating second edition of this CD.
Feed back from my student was very important in making changes and
improvements in this second edition.
The Dean of our college Dr A.V.Bhore is a constant source of inspiration. His
encouragement in all the academic activities
have helped us to bring best within us .
Professor M.N. Navale founder director of Sinhgad Technical Education Society
which runs the medical college and hospital is a constant source of motivation.
He has given us the best of infrastructure, equipment and manpower , giving us
the opportunity to create center of excellence.
This must be one of the unique case of charity where the best is available to the
neediest patients absolutely free.
All of us are touched by his humane nature, simplicity and caring attitude.
Dr Damle Hemant S.
file:///E|/CDInstruments/Dec2009Updates/acknowlegement.htm [08/12/2009 05:27:53 AM]
59. Dr Damle Hemant S Inst In Obs/Gyn
<<<< Back To Index About the Author
Dr Damle Hemant Shrikrishna
M.D. (Obs/Gyn)
Professor& Head , Dept. of Obs/ Gyn
Smt. Kashibai Nawale Medical College
Sinhgad Road Narhe Pune.
Tel : 9422032020 / E Mail damle1@hotmail.com
Web Page : http://medico.itgo.com
file:///E|/DrDamleHemant/DamleHS.htm (1 of 2) [4/22/2006 8:55:29 PM]