SlideShare a Scribd company logo
VENTOUSE DELIVERY
Anjana Thomas
Description
 It is an instrumental device designed to assist
delivery by creating a vacuum (negative pressure)
between itself and the fetal scalp.
Definition
 Vaccum extraction also known as ventouse, is a
method to assist delivery of a baby using a vacuum
device. It is a instrumental delivery to assist delivery
by creating a vaccum between it and the fetal scalp.
Equipment Description
 Vacuum extractor is composed of:
 A specially designed cup with a diameter of 3,4,5,6
cm or 30,40,50,60 mm.
 A rubber tube attaching the cup to a glass bottle with
a screw in between to release the negative pressure.
 A manometer fitted in the mouth of the glass bottle to
declare the negative pressure.
 Another rubber tube connecting the bottle to a
suction piece which may be manual or electronic
creating a negative pressure that should not exceed-
0.8 kg per cm2
Part
 Suction cup of variable sizes. It is either metallic or
soft made of silicone .
 Vacuum generator.
 Traction tubing.
Type
 Malmstrom cup
A metal cup to its centre attached a metal chain
passed through the rubber tube. The other end of
the chain is attached to a handle for traction
 Bird’s cup
The suction rubber tube is attached to the periphery
of the cup while the handle of traction is attached by
a separate short metal chain to the centre of the cup.
 Soft cup
It is a bell shaped 6.5 cm diameter soft cup which is
made of a firm but supple silastic material.
 Kiwi cup
It is fexible stem and low profile cup enable
placement over the flexion point of the baby’s head
no matter the fetal head position.
Indications
 Maternal indication
 Maternal distress: exhaustion after a long, painful
labor due to inefficient uterine contraction.
 Prolonged second stage of labor.
 Maternal medical disorders such as heart diseases,
HTN and anemia
 Previous cesarean section or genital prolapse repair.
 Premature separation of placenta.
 Fetal indication
 Deep transverse arrest with adequate pelvis.
 Delay in descend of the high head in case of the
second baby of twins.
 Malposition : occipitolateral and occipito posterior.
 As an alternative to forceps exept in face
presentation and brreech.
 Fetal distress
Contraindication
 Operator inexperience
 Inability to assess fetal position
 Suspicion of cephalopelvic disproportion
 Fetal coagulopathy
 Preterm babies due to risk of fetal intraventricular
hemorrhage.
 Macrosomia >4kg
 Soft tissues obstruction in the pelvis
 Breach presentation and face presentation
Condition to be fulfilled
 There should not be any bony resistance below the
head
 The head of a singleton baby should be engaged
 Cervix should be at least 6 cm dilated.
Prerequisites
 Bladder must be emptied
 Cervix fully dilated
 No evidence of CPD
 Vertex presentation and not above the station of +2
 Membrane must be ruptured
Technique
 Application
 Station of the head and its position is assessed
 Instrument is checked to be in working condition
before application
 Selection of cup is important
 The cup is introduced after retraction of perineum
with two fingers of the other hand
 The centre of the cup should be on the flexion point
of the head, which is a point located on the sagittal
suture, 3cm in front of posterior fontanelle.
 Traction at this point results in maximum
flexion(flexing median application)
 Proper cup placement over flexion point
 Exclude maternal soft tissue entrapment by
palpation
 Vacuum creation by increasing the suction in
increments of 0.2 kg/cm2 every 2 mins until 0.8
kg/cm2
 A check is made using the fingers round the cup to
ensure that no cervical or vaginal tissue is trapped
inside the cup .
 The pressure is gradually raised at the rate of
0.1kg/cm2 per minute until the effective vacuum of
0.8kg/cm2 is achieved in about 10 minutes time
 The scalp is sucked into the cup and an artificial
 Instrument handle is grasped, and initiation of
traction.
 Traction is initiated by using a two-handed
technique, i.e the fingers of one hand are placed
against the suction cup, while the other hand grasps
the handle of the instrument
 Traction must be at right angle to the cup
 Traction directed initially downward then
progressively extended upward as head emerge.
 Traction should be synchronous with the uterine
 Once head is extracted, vacuum pressure is
relieved; cup is removed; vaginal delivery followed.
 The total time from the application until delivery
should not exceed 20 minutes.
 If >20 minutes, the risk of fetal scalp trauma and
intracranial damage increases.
 Many pulls to achieve progress should not be done .
 The operator should be wiling to abandon the
procedure if it does not proceed easily or if the cup
dislodges >3 times
Vacuum application
Complications
 Fetal complications
 Scalp laceration and bruising
 Subglial hematoma, Cephalohematoma
 Intracranial hemorrhage, intraventricular and
cerebral hemorrhages
 Retinal and sub-conjunctival hemorrhages
 Neonatal jaundice
 Clavicular fracture, Shoulder dystocia
 Injury to CVI, CVII nerves, Erb palsy
 Hypoxia, particularly when extraction has taken a
long time and has been difficult
 Fetal death
 Maternal complications
 Soft tissues injuries such as cervical tears, annular
detachment of the cervix, vaginal tears, perineal
lacerations and tears, extension of episiotomy,
vaginal wall and perineal hematomas.
 Traumatic postpartum hemorrhages
 Infection
 Genital prolapse
Management
Along with normal delivery management :
 To assess the effect on the mother and the fetus
 To start a Ringer’s solution drip and to arrange for
blood transfusion, if required
 To exclude rupture of the uterus
 To assess if procedure is to be abandoned and
consider delivery by cesarean section
 Laparotomy should be done in a case with rupture of
uterus.
 To administer parenteral antibiotic
Ventouse delivery

More Related Content

What's hot

Destructive operation
Destructive operationDestructive operation
Destructive operation
PRANATI PATRA
 
PRE -ECLAMPSIA
 PRE -ECLAMPSIA PRE -ECLAMPSIA
PRE -ECLAMPSIA
Agasthiya Sivaraj
 
Vasa previa
Vasa previaVasa previa
Vasa previa
Priyanka Gohil
 
Destructive operations
Destructive operationsDestructive operations
Destructive operations
Neethu Satheesan
 
Incomplete abortion
Incomplete abortion Incomplete abortion
Incomplete abortion
akshaya r nair
 
Presentation episiotomy
Presentation episiotomyPresentation episiotomy
Presentation episiotomy
suji kalai
 
Vacuum extraction (ventouse)
Vacuum extraction (ventouse)Vacuum extraction (ventouse)
Vacuum extraction (ventouse)
raj kumar
 
Second stage of labour
Second stage of labour Second stage of labour
Second stage of labour
sakshi rana
 
Inversion Of Uterus
Inversion Of UterusInversion Of Uterus
Inversion Of Uterus
Abhishek Joshi
 
Non-stress test, and contraction stress test, presentation
Non-stress test, and contraction stress test,  presentationNon-stress test, and contraction stress test,  presentation
Non-stress test, and contraction stress test, presentation
Kanchan Mehra
 
Rupture of the uterus
Rupture of the uterusRupture of the uterus
Rupture of the uterus
Fahad Zakwan
 
Prolonged labour
Prolonged labourProlonged labour
Prolonged labour
Priyanka Gohil
 
Cord prolapse
Cord prolapseCord prolapse
Cord prolapse
Priyanka Gohil
 
Placenta examination
Placenta examinationPlacenta examination
Placenta examination
Mkangi Sospeter
 
Aph
AphAph
POLYHYDRAMINOS
POLYHYDRAMINOSPOLYHYDRAMINOS
POLYHYDRAMINOS
Snehlata Parashar
 
Obstetrical shock
Obstetrical shockObstetrical shock
Obstetrical shock
Priyanka Gohil
 
Retained placenta
Retained placentaRetained placenta
Retained placenta
krishnasagar1910
 
Second stage of labor
Second stage of laborSecond stage of labor
Second stage of labor
DR MUKESH SAH
 
Rupture uterus
Rupture uterusRupture uterus
Rupture uterus
muhammad al hennawy
 

What's hot (20)

Destructive operation
Destructive operationDestructive operation
Destructive operation
 
PRE -ECLAMPSIA
 PRE -ECLAMPSIA PRE -ECLAMPSIA
PRE -ECLAMPSIA
 
Vasa previa
Vasa previaVasa previa
Vasa previa
 
Destructive operations
Destructive operationsDestructive operations
Destructive operations
 
Incomplete abortion
Incomplete abortion Incomplete abortion
Incomplete abortion
 
Presentation episiotomy
Presentation episiotomyPresentation episiotomy
Presentation episiotomy
 
Vacuum extraction (ventouse)
Vacuum extraction (ventouse)Vacuum extraction (ventouse)
Vacuum extraction (ventouse)
 
Second stage of labour
Second stage of labour Second stage of labour
Second stage of labour
 
Inversion Of Uterus
Inversion Of UterusInversion Of Uterus
Inversion Of Uterus
 
Non-stress test, and contraction stress test, presentation
Non-stress test, and contraction stress test,  presentationNon-stress test, and contraction stress test,  presentation
Non-stress test, and contraction stress test, presentation
 
Rupture of the uterus
Rupture of the uterusRupture of the uterus
Rupture of the uterus
 
Prolonged labour
Prolonged labourProlonged labour
Prolonged labour
 
Cord prolapse
Cord prolapseCord prolapse
Cord prolapse
 
Placenta examination
Placenta examinationPlacenta examination
Placenta examination
 
Aph
AphAph
Aph
 
POLYHYDRAMINOS
POLYHYDRAMINOSPOLYHYDRAMINOS
POLYHYDRAMINOS
 
Obstetrical shock
Obstetrical shockObstetrical shock
Obstetrical shock
 
Retained placenta
Retained placentaRetained placenta
Retained placenta
 
Second stage of labor
Second stage of laborSecond stage of labor
Second stage of labor
 
Rupture uterus
Rupture uterusRupture uterus
Rupture uterus
 

Similar to Ventouse delivery

Vacuum Extraction of fetus.pptx
Vacuum Extraction of fetus.pptxVacuum Extraction of fetus.pptx
Vacuum Extraction of fetus.pptx
SrishtiGupta304
 
OBSTETRICAL PROCEDURES AND OPERATIONS.pptx
OBSTETRICAL PROCEDURES AND OPERATIONS.pptxOBSTETRICAL PROCEDURES AND OPERATIONS.pptx
OBSTETRICAL PROCEDURES AND OPERATIONS.pptx
ManoharsinhParmar1
 
Instrumental vaginaldelivery...
Instrumental  vaginaldelivery...Instrumental  vaginaldelivery...
Instrumental vaginaldelivery...
imanswati
 
Vacuum extraction
Vacuum extractionVacuum extraction
Vacuum extraction
Reshma Susan
 
Ventouse in obgyn
Ventouse in obgynVentouse in obgyn
Ventouse in obgyn
farranajwa
 
OBS Operation.pptx
OBS Operation.pptxOBS Operation.pptx
Gyula Richard Nagy: Obstetric operations
Gyula Richard Nagy: Obstetric operationsGyula Richard Nagy: Obstetric operations
Gyula Richard Nagy: Obstetric operations
Katalin Cseh
 
Pathophysiology of Normal Labour by Sunil Kumar Daha
Pathophysiology  of Normal Labour by Sunil Kumar DahaPathophysiology  of Normal Labour by Sunil Kumar Daha
Pathophysiology of Normal Labour by Sunil Kumar Daha
sunil kumar daha
 
LSCS
LSCSLSCS
VACCUM ASSISTED DELIVERY
VACCUM ASSISTED DELIVERYVACCUM ASSISTED DELIVERY
VACCUM ASSISTED DELIVERY
sony arun
 
Vacuum Delivery OSCE
Vacuum Delivery OSCEVacuum Delivery OSCE
Vacuum Delivery OSCE
nicoletanww
 
Normal Labor in Obstetrics
Normal Labor in ObstetricsNormal Labor in Obstetrics
Normal Labor in Obstetrics
Dr. Aryan (Anish Dhakal)
 
3rd stage OF LABOUR
3rd stage OF LABOUR 3rd stage OF LABOUR
3rd stage OF LABOUR
Amandeep Jhinjar
 
EPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptxEPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptx
SapnaJaggiMarkan
 
EPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptxEPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptx
SapnaJaggiMarkan
 
Stages of labour
Stages of labourStages of labour
Stages of labour
Ishta Thakur
 
Special circumstances during labour by UM
Special circumstances during labour by UMSpecial circumstances during labour by UM
Special circumstances during labour by UM
Dr. Rubz
 
Lower segmental caesarian section tray
Lower segmental caesarian section trayLower segmental caesarian section tray
Lower segmental caesarian section tray
principal phoenix paramedical college pulwama kashmir
 
lowersegmentalcaesariansectiontray-190513181406.pdf
lowersegmentalcaesariansectiontray-190513181406.pdflowersegmentalcaesariansectiontray-190513181406.pdf
lowersegmentalcaesariansectiontray-190513181406.pdf
MaylynAngalan1
 
11. VACUUM DELIVERY.ppt
11. VACUUM DELIVERY.ppt11. VACUUM DELIVERY.ppt
11. VACUUM DELIVERY.ppt
AugustusCaesar7
 

Similar to Ventouse delivery (20)

Vacuum Extraction of fetus.pptx
Vacuum Extraction of fetus.pptxVacuum Extraction of fetus.pptx
Vacuum Extraction of fetus.pptx
 
OBSTETRICAL PROCEDURES AND OPERATIONS.pptx
OBSTETRICAL PROCEDURES AND OPERATIONS.pptxOBSTETRICAL PROCEDURES AND OPERATIONS.pptx
OBSTETRICAL PROCEDURES AND OPERATIONS.pptx
 
Instrumental vaginaldelivery...
Instrumental  vaginaldelivery...Instrumental  vaginaldelivery...
Instrumental vaginaldelivery...
 
Vacuum extraction
Vacuum extractionVacuum extraction
Vacuum extraction
 
Ventouse in obgyn
Ventouse in obgynVentouse in obgyn
Ventouse in obgyn
 
OBS Operation.pptx
OBS Operation.pptxOBS Operation.pptx
OBS Operation.pptx
 
Gyula Richard Nagy: Obstetric operations
Gyula Richard Nagy: Obstetric operationsGyula Richard Nagy: Obstetric operations
Gyula Richard Nagy: Obstetric operations
 
Pathophysiology of Normal Labour by Sunil Kumar Daha
Pathophysiology  of Normal Labour by Sunil Kumar DahaPathophysiology  of Normal Labour by Sunil Kumar Daha
Pathophysiology of Normal Labour by Sunil Kumar Daha
 
LSCS
LSCSLSCS
LSCS
 
VACCUM ASSISTED DELIVERY
VACCUM ASSISTED DELIVERYVACCUM ASSISTED DELIVERY
VACCUM ASSISTED DELIVERY
 
Vacuum Delivery OSCE
Vacuum Delivery OSCEVacuum Delivery OSCE
Vacuum Delivery OSCE
 
Normal Labor in Obstetrics
Normal Labor in ObstetricsNormal Labor in Obstetrics
Normal Labor in Obstetrics
 
3rd stage OF LABOUR
3rd stage OF LABOUR 3rd stage OF LABOUR
3rd stage OF LABOUR
 
EPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptxEPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptx
 
EPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptxEPISIOTOMY AND ITS REPAIR.pptx
EPISIOTOMY AND ITS REPAIR.pptx
 
Stages of labour
Stages of labourStages of labour
Stages of labour
 
Special circumstances during labour by UM
Special circumstances during labour by UMSpecial circumstances during labour by UM
Special circumstances during labour by UM
 
Lower segmental caesarian section tray
Lower segmental caesarian section trayLower segmental caesarian section tray
Lower segmental caesarian section tray
 
lowersegmentalcaesariansectiontray-190513181406.pdf
lowersegmentalcaesariansectiontray-190513181406.pdflowersegmentalcaesariansectiontray-190513181406.pdf
lowersegmentalcaesariansectiontray-190513181406.pdf
 
11. VACUUM DELIVERY.ppt
11. VACUUM DELIVERY.ppt11. VACUUM DELIVERY.ppt
11. VACUUM DELIVERY.ppt
 

More from Datta meghe institute of medical sciences

THE REPRODUCTIVE SYSTEM.pptx
THE REPRODUCTIVE SYSTEM.pptxTHE REPRODUCTIVE SYSTEM.pptx
THE REPRODUCTIVE SYSTEM.pptx
Datta meghe institute of medical sciences
 
organization of clinics.pptx
organization of clinics.pptxorganization of clinics.pptx
organization of clinics.pptx
Datta meghe institute of medical sciences
 
occupational health.pptx
occupational health.pptxoccupational health.pptx
Hospital admission and discharge.pptx
Hospital admission and discharge.pptxHospital admission and discharge.pptx
Hospital admission and discharge.pptx
Datta meghe institute of medical sciences
 
unit v documentation.pptx
unit v documentation.pptxunit v documentation.pptx
communication- non therapeutic, NPR
communication- non therapeutic, NPRcommunication- non therapeutic, NPR
communication- non therapeutic, NPR
Datta meghe institute of medical sciences
 
CURRICULUM.pptx
CURRICULUM.pptxCURRICULUM.pptx
Hematological disorders in pregnancy
Hematological disorders in pregnancyHematological disorders in pregnancy
Hematological disorders in pregnancy
Datta meghe institute of medical sciences
 
Displacement of the uterus
Displacement of the uterusDisplacement of the uterus
Displacement of the uterus
Datta meghe institute of medical sciences
 
Hepatitis
HepatitisHepatitis
career opportunities in nursing
career opportunities in nursing career opportunities in nursing
career opportunities in nursing
Datta meghe institute of medical sciences
 
Cold injury
Cold injuryCold injury
methergin and clomiphene citrate
methergin and clomiphene citrate methergin and clomiphene citrate
methergin and clomiphene citrate
Datta meghe institute of medical sciences
 
Rh incompatibility
Rh incompatibilityRh incompatibility
quality of nursing care and services
quality of nursing care and servicesquality of nursing care and services
quality of nursing care and services
Datta meghe institute of medical sciences
 
Physical examination- Images
Physical examination- Images Physical examination- Images
Physical examination- Images
Datta meghe institute of medical sciences
 

More from Datta meghe institute of medical sciences (16)

THE REPRODUCTIVE SYSTEM.pptx
THE REPRODUCTIVE SYSTEM.pptxTHE REPRODUCTIVE SYSTEM.pptx
THE REPRODUCTIVE SYSTEM.pptx
 
organization of clinics.pptx
organization of clinics.pptxorganization of clinics.pptx
organization of clinics.pptx
 
occupational health.pptx
occupational health.pptxoccupational health.pptx
occupational health.pptx
 
Hospital admission and discharge.pptx
Hospital admission and discharge.pptxHospital admission and discharge.pptx
Hospital admission and discharge.pptx
 
unit v documentation.pptx
unit v documentation.pptxunit v documentation.pptx
unit v documentation.pptx
 
communication- non therapeutic, NPR
communication- non therapeutic, NPRcommunication- non therapeutic, NPR
communication- non therapeutic, NPR
 
CURRICULUM.pptx
CURRICULUM.pptxCURRICULUM.pptx
CURRICULUM.pptx
 
Hematological disorders in pregnancy
Hematological disorders in pregnancyHematological disorders in pregnancy
Hematological disorders in pregnancy
 
Displacement of the uterus
Displacement of the uterusDisplacement of the uterus
Displacement of the uterus
 
Hepatitis
HepatitisHepatitis
Hepatitis
 
career opportunities in nursing
career opportunities in nursing career opportunities in nursing
career opportunities in nursing
 
Cold injury
Cold injuryCold injury
Cold injury
 
methergin and clomiphene citrate
methergin and clomiphene citrate methergin and clomiphene citrate
methergin and clomiphene citrate
 
Rh incompatibility
Rh incompatibilityRh incompatibility
Rh incompatibility
 
quality of nursing care and services
quality of nursing care and servicesquality of nursing care and services
quality of nursing care and services
 
Physical examination- Images
Physical examination- Images Physical examination- Images
Physical examination- Images
 

Recently uploaded

Abnormal CSF Diagnosis and Lumbar puncture
Abnormal CSF Diagnosis and Lumbar punctureAbnormal CSF Diagnosis and Lumbar puncture
Abnormal CSF Diagnosis and Lumbar puncture
Preet Mehta
 
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptxselllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
Joebest8
 
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in DohaAbortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
maishakhanam230
 
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptxNosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
jeearu
 
11_Eclampsia and preeclampsia real.pptxf
11_Eclampsia and preeclampsia real.pptxf11_Eclampsia and preeclampsia real.pptxf
11_Eclampsia and preeclampsia real.pptxf
kkamaraansumana
 
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxPOTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
souravpaul769171
 
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptxOperation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
RadhaThapaChhetry
 
Prodrug design for Sustained Drug action -.KB.pptx
Prodrug design for Sustained Drug action -.KB.pptxProdrug design for Sustained Drug action -.KB.pptx
Prodrug design for Sustained Drug action -.KB.pptx
ANAGHA K B
 
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.GawadHemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
NephroTube - Dr.Gawad
 
Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...
Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...
Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...
Dr.Nishant Janu
 
PULMONARY DRUG DELIVERY SYSTEM......pptx
PULMONARY DRUG DELIVERY SYSTEM......pptxPULMONARY DRUG DELIVERY SYSTEM......pptx
PULMONARY DRUG DELIVERY SYSTEM......pptx
PRAMESHPANWAR1
 
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptxWhy Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
AmandaChou9
 
Complete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and More
Complete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and MoreComplete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and More
Complete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and More
Donald Coomer
 
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...
rightmanforbloodline
 
Mainstreaming #CleanLanguage in healthcare.pptx
Mainstreaming #CleanLanguage in healthcare.pptxMainstreaming #CleanLanguage in healthcare.pptx
Mainstreaming #CleanLanguage in healthcare.pptx
Judy Rees
 
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx  Keynotes by H.C. AllenAGARICUS MUSCARIUS.pptx  Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
DR.P.S SUDHAKAR
 
How to build a successful medical tourism practice
How to build a successful medical tourism practiceHow to build a successful medical tourism practice
How to build a successful medical tourism practice
Arlen Meyers, MD, MBA
 
Veterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in IndiaVeterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in India
Heilsaa Care
 
FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...
FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...
FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...
PratibhaSonawane5
 
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan PatroJULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
Kanhu Charan
 

Recently uploaded (20)

Abnormal CSF Diagnosis and Lumbar puncture
Abnormal CSF Diagnosis and Lumbar punctureAbnormal CSF Diagnosis and Lumbar puncture
Abnormal CSF Diagnosis and Lumbar puncture
 
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptxselllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
 
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in DohaAbortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
 
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptxNosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
 
11_Eclampsia and preeclampsia real.pptxf
11_Eclampsia and preeclampsia real.pptxf11_Eclampsia and preeclampsia real.pptxf
11_Eclampsia and preeclampsia real.pptxf
 
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxPOTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
 
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptxOperation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
 
Prodrug design for Sustained Drug action -.KB.pptx
Prodrug design for Sustained Drug action -.KB.pptxProdrug design for Sustained Drug action -.KB.pptx
Prodrug design for Sustained Drug action -.KB.pptx
 
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.GawadHemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
 
Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...
Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...
Gestational Trophoblastic Disease( GTD)- Molar pregnancy, Gestational Trophob...
 
PULMONARY DRUG DELIVERY SYSTEM......pptx
PULMONARY DRUG DELIVERY SYSTEM......pptxPULMONARY DRUG DELIVERY SYSTEM......pptx
PULMONARY DRUG DELIVERY SYSTEM......pptx
 
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptxWhy Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
 
Complete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and More
Complete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and MoreComplete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and More
Complete Buying Guide to Modafresh 200mg Tablets: Dosage, Benefits, and More
 
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...
 
Mainstreaming #CleanLanguage in healthcare.pptx
Mainstreaming #CleanLanguage in healthcare.pptxMainstreaming #CleanLanguage in healthcare.pptx
Mainstreaming #CleanLanguage in healthcare.pptx
 
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx  Keynotes by H.C. AllenAGARICUS MUSCARIUS.pptx  Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
 
How to build a successful medical tourism practice
How to build a successful medical tourism practiceHow to build a successful medical tourism practice
How to build a successful medical tourism practice
 
Veterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in IndiaVeterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in India
 
FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...
FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...
FSSAI act, Food safety act, Food safety and standards act 2006, Rules and reg...
 
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan PatroJULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
 

Ventouse delivery

  • 2. Description  It is an instrumental device designed to assist delivery by creating a vacuum (negative pressure) between itself and the fetal scalp.
  • 3. Definition  Vaccum extraction also known as ventouse, is a method to assist delivery of a baby using a vacuum device. It is a instrumental delivery to assist delivery by creating a vaccum between it and the fetal scalp.
  • 4. Equipment Description  Vacuum extractor is composed of:  A specially designed cup with a diameter of 3,4,5,6 cm or 30,40,50,60 mm.  A rubber tube attaching the cup to a glass bottle with a screw in between to release the negative pressure.  A manometer fitted in the mouth of the glass bottle to declare the negative pressure.  Another rubber tube connecting the bottle to a suction piece which may be manual or electronic creating a negative pressure that should not exceed- 0.8 kg per cm2
  • 5. Part  Suction cup of variable sizes. It is either metallic or soft made of silicone .  Vacuum generator.  Traction tubing.
  • 6. Type  Malmstrom cup A metal cup to its centre attached a metal chain passed through the rubber tube. The other end of the chain is attached to a handle for traction
  • 7.  Bird’s cup The suction rubber tube is attached to the periphery of the cup while the handle of traction is attached by a separate short metal chain to the centre of the cup.
  • 8.  Soft cup It is a bell shaped 6.5 cm diameter soft cup which is made of a firm but supple silastic material.
  • 9.  Kiwi cup It is fexible stem and low profile cup enable placement over the flexion point of the baby’s head no matter the fetal head position.
  • 10. Indications  Maternal indication  Maternal distress: exhaustion after a long, painful labor due to inefficient uterine contraction.  Prolonged second stage of labor.  Maternal medical disorders such as heart diseases, HTN and anemia  Previous cesarean section or genital prolapse repair.  Premature separation of placenta.
  • 11.  Fetal indication  Deep transverse arrest with adequate pelvis.  Delay in descend of the high head in case of the second baby of twins.  Malposition : occipitolateral and occipito posterior.  As an alternative to forceps exept in face presentation and brreech.  Fetal distress
  • 12. Contraindication  Operator inexperience  Inability to assess fetal position  Suspicion of cephalopelvic disproportion  Fetal coagulopathy  Preterm babies due to risk of fetal intraventricular hemorrhage.  Macrosomia >4kg  Soft tissues obstruction in the pelvis  Breach presentation and face presentation
  • 13. Condition to be fulfilled  There should not be any bony resistance below the head  The head of a singleton baby should be engaged  Cervix should be at least 6 cm dilated.
  • 14. Prerequisites  Bladder must be emptied  Cervix fully dilated  No evidence of CPD  Vertex presentation and not above the station of +2  Membrane must be ruptured
  • 15. Technique  Application  Station of the head and its position is assessed  Instrument is checked to be in working condition before application  Selection of cup is important  The cup is introduced after retraction of perineum with two fingers of the other hand  The centre of the cup should be on the flexion point of the head, which is a point located on the sagittal suture, 3cm in front of posterior fontanelle.
  • 16.  Traction at this point results in maximum flexion(flexing median application)
  • 17.  Proper cup placement over flexion point  Exclude maternal soft tissue entrapment by palpation
  • 18.  Vacuum creation by increasing the suction in increments of 0.2 kg/cm2 every 2 mins until 0.8 kg/cm2  A check is made using the fingers round the cup to ensure that no cervical or vaginal tissue is trapped inside the cup .  The pressure is gradually raised at the rate of 0.1kg/cm2 per minute until the effective vacuum of 0.8kg/cm2 is achieved in about 10 minutes time  The scalp is sucked into the cup and an artificial
  • 19.  Instrument handle is grasped, and initiation of traction.  Traction is initiated by using a two-handed technique, i.e the fingers of one hand are placed against the suction cup, while the other hand grasps the handle of the instrument  Traction must be at right angle to the cup  Traction directed initially downward then progressively extended upward as head emerge.  Traction should be synchronous with the uterine
  • 20.  Once head is extracted, vacuum pressure is relieved; cup is removed; vaginal delivery followed.  The total time from the application until delivery should not exceed 20 minutes.  If >20 minutes, the risk of fetal scalp trauma and intracranial damage increases.  Many pulls to achieve progress should not be done .  The operator should be wiling to abandon the procedure if it does not proceed easily or if the cup dislodges >3 times
  • 22. Complications  Fetal complications  Scalp laceration and bruising  Subglial hematoma, Cephalohematoma  Intracranial hemorrhage, intraventricular and cerebral hemorrhages  Retinal and sub-conjunctival hemorrhages  Neonatal jaundice  Clavicular fracture, Shoulder dystocia  Injury to CVI, CVII nerves, Erb palsy  Hypoxia, particularly when extraction has taken a long time and has been difficult  Fetal death
  • 23.  Maternal complications  Soft tissues injuries such as cervical tears, annular detachment of the cervix, vaginal tears, perineal lacerations and tears, extension of episiotomy, vaginal wall and perineal hematomas.  Traumatic postpartum hemorrhages  Infection  Genital prolapse
  • 24. Management Along with normal delivery management :  To assess the effect on the mother and the fetus  To start a Ringer’s solution drip and to arrange for blood transfusion, if required  To exclude rupture of the uterus  To assess if procedure is to be abandoned and consider delivery by cesarean section  Laparotomy should be done in a case with rupture of uterus.  To administer parenteral antibiotic