This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
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 topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
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 topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction
under and post graduate best presentation ever about the assisted vaginal delivery,operative vaginal delivery, or instrumental vaginal delivery.
done by waill salan al.timeemi/stager 2014-2015/ Iraq-al.qadisiyyah college of medicine.
In this slide you will get to know about what is second stage of labor and what are cardinal movements in mechanism of labor and its management are discussed in this slide
This topic contains Gametogenesis- oogenesis and spermatogenesis, ovulation, fertilization, development of fertilized ovum/ zygote, implantation, development of decidua, chorion and chorionic villi, development of inner cell mass.
This topic includes menstruation:- its definition, anatomical aspects- follicular growth and atresia, germ cells, premodial follicle; menstrual cycle/ ovarian cycle:- definition, phases- recruitment of groups of follicles (premature phase), selection of dominant follicle and its maturation, ovulation, follicular atresia; Endometrial cycle:- division of endometrium- basal zone, functional zone and its phases- stage of regeneration, stage of proliferation, secretory phase, menstrual phase, mechanism of menstrual bleeding, role of prostaglandins, hormones in relation to ovarian and menstrual cycle, ovulation, luteal-follicular shift, menstrual symptoms, menstrual hygiene, anovular menstruation, artificial postponement; cervical cycle, vaginal cycle and general changes in follicular and luteal phase.
This topic includes difference between female and male pelvis, various pelvis types, general description of pelvis bones, division of pelvis, landmarks of pelvis, plane, axis, sacral angle, diameters of inlet, cavity and outlet.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
This topic includes Introduction, common side effects from maternal medications on infants, guidelines for medication during lactation, effects of various medications on lactation and neonates
This topic contains anticonvulsants used in obstetrics such as magnasium sulphate, diazepam, phenytoin and anticoagulants such as heparin and warfarin.
It is from biochemistry subject and continuation of previous topic from organization of matter. This topic contains definition of Chemistry, Matter, Mass, Weight. Description of physical state of matter and chemical structure of matter.
link for previous topic: organization of matter- important terms
https://www.slideshare.net/priyankagohil10/organization-of-matter-important-terms-237314150
Vital statistics related to maternal health in indiaPriyanka Gohil
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This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
Presentation on this topic is available on link đ
https://youtu.be/d_JgNiYv7eU
This topic contains detail about genital prolapse in pregnancy, It's definition, incidence, types, stages, causes, risk factors, clinical features, effect of prolapse, effect on pregnancy, effect during labour and puerperium, prevention, treatment and nursing management during pregnancy, labour and puerperium.
This topic contains definition, incidence, varieties, causes, risk factors, dangers, diagnosis, prognosis, prevention and management of inversion of uterus.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
This topic contains definition, meaning, classification, pathophysiology, clinical menifestations, metabolic and general changes, management of obstetrical shock
Tom Selleck Health: A Comprehensive Look at the Iconic Actorâs Wellness Journeygreendigital
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Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowmanâs Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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, Ganongâs 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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: Whatâs the Latest in Cervical Cancer?bkling
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Are you curious about whatâs new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Womenâs Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganongâs Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. īâ Ventouse is an instrumental device
designed to assist delivery by creating a
vaccum between it and the fetal scalp.â
īThe pulling force is dragging the
cranium while in forceps, the pulling
force is directly transmitted to the base
of skull.
3. ī Ever since Malmstrom in 1956 reintroduced and
popularized its use, various modifications of the
instruments are now available.
ī Each, however, consists of the following basic
components:
1. Suction cup with 4 sizes (30,40,50,60 mm)
2. A vaccum pump with a manometer attached
to it (modern vaccum extractors consists of
an electrical pump)
3. Traction rod device
4. Rubber tubing with a chain in the centre.
4. ī Metal cups were initially used.
ī Soft cups, silc cups (silicone rubber or
dispossable plastic- mityvac cups) have better
adherence to the fetal scalp.
ī These cups could be folded and introduced into
the vagina without much discomfort.
ī Silastic cup causes less scalp trauma and there
is no chignon formation.
ī Rigid plastic cup (Kiwi Omnicup) is safe,
effective and is useful for rotational delivery.
5.
6.
7. īŧ Deep transverse arrest with adequate pelvis.
īŧ Delay in descent of the high head in case of
second baby of twins.
īŧ As an alternative of forceps operation except:
a. Face presentation and after coming head of breech
b. Fetal distress or prematurity
c. Delay in late first stage of labour due to uterine
inertia or primary cervical dystocia
d. As an adjunct to symphysiotomy
e. Prolonged second stage of labour
f. If rotation of caput from posterior to anterior position
8. ī¯ Unengaged fetal head
ī¯ Obvious CPD
ī¯ Paient's Refusal
ī¯ Fetus having unacute bleeding
diathesis (hemophilia).
9. FETAL & MATERNAL CRITERIA
īŧFetal head engaged (head is ⤠1/5 palpable
per abdomen)
īŧThe cervix must be fully dilated
īŧThe membranes must be ruptured
īŧFetal head position is exactly known
īŧPelvis deemed adequate
īŧBladder must be emptied
īŧAdequate maternal analgesia
īŧInformed consent
10. OTHERS
īŧ Experienced operator
īŧ Aseptic techniques
īŧ Back up plan in case of failure
īŧ Presence of a neonatologist
īŧ Willingness to abandon the procedure when
difficulties faced
11. īŧ It can be used in unrotated or malrotated head
(OP, OT position). It helps in autorotation
īŧ It is not a space occupying device likee the
forceps blades
īŧ It is comfortable and had lower rates of
maternal trauma and ganital tract lacerations
īŧ Analgesia need is less. Pudendal block with
perineal infiltration is adequate but for
forceps regional or general anesthesia is
often needed.
12. īŧ Reduced maternal pelvic floor injuries and is
advocated as the instrument of first choice
īŧ Perineal injury (3rd and 4th degree tears) are
less compared to forceps.
īŧ Postpartum maternal discomfort (pain) are
less compared to forceps.
īŧ Easier to learn comparing to forceps
īŧ Simplicilty of use in delivery makes it
convenient to the operator (suitable for
trained midwives)
13. PRELIMINERIES
īAnesthesia - Pudendal block or perineal
infiltration with 1% lignocaine is sufficient.
īIt can be applied even without anesthesi in
parous women.
īThe patient should be placed in lithotomy
position
īFull surgical sepsis is to be taken
īBladder must be emptied.
īVaginal examination is done.
īThe instrument should be assembled and the
vaccum is tested prior to its application.
14.
15. ī The largest possible cup according to the
dilatation of the cervix is to be selected.
ī The cup is introduced after retraction of the
perineum with two fingers of the other hand.
ī The cup is placed against the fetal head nearer
to the occiput (flexion point) with the âknobâ of
the cup pointing towards the occiput.
ī This will facilitate flexion of the head and the
knob indicates the degree of rotation.
ī Betadine solution is applied to the rim of the
malmstrom metal cup.
16. Flexion or pivot point is an imaginary site
located midsagitally aout 6 cm from the centre
of the anterior fontanallae or about 3 cm front
of the posterior fontanallae.
17. PRESSURE & DURATION OF VACCUM
īA vaccumof 2.0 kg/cm2 is induced by the pump
slowly, taking at least 2 minutes.
īA check is made using the fingers round the
cup to ensure that no cervical or vaginal tissue is
trapped inside the cup.
īThe presure is gradually raised at the rate of 0.1
kg/cm2 per minute until the effective vaccum of
0.8 kg/cm2 is achieved in about 10 minutes time.
18. CHIGNON FORMATION
ī The scalp is sucked into the cup and an
artificial caput succedaneum / chignon is
produced.
ī The chignon usually disappears within few
hours.
19. ī Traction must be at right angle to the cup
ī Traction should be synchronous with the
uterine contractions
ī Traction is released in between uterine
contractions
ī Traction should be made using one hand along
the axis of the birth canal.
ī The fingers of the other hand are to be placed
against the cup to note the correct angle of
traction, rotation and advancement of the head.
20. ī Operative vaginal delivery (Forceps/vaccum)
should be abandoned, where there is no
descent of the presenting part with each pull or
when delivery is not imminent after three pulls
with correctly applied instruments by an
experienced operator.
ī On no account, traction should exceed 30
minutes.
ī As soon as the head is delivered, t vaccum is
reduced by opening the screw-release valve
and the cup is then detached.
ī The delivery is then completed in the normal
way.
21. Application of vaccum extractor A, B, C,
indicating the directions of traction at
different stations of the fetal head.
Traction over the flexion point either by
ventouse / forceps promotes flexion and
presents smaller diameter to the pelvis.
22. FETAL
ī Superficial scalp abrasion
ī Sloughing of the scalp
ī Cephalhematoma due to rupture of emissary
veins beneath the periosteum. Usually it
resolves by one or two weeks
ī Subaponeurotic hemorrhage
ī Cerebral trauma (tentorial tear)
ī Jaundice
MATERNAL
ī Lacerations of cervix or vaginal wall.
23. FETAL
ī Sloughing of the scalp
ī Cephalhematoma
ī Subaponeurotic hemorrhage (not limited by
suture line as it is not subperiosteal)
ī Intra-cranial hemorrhage (rare)
MATERNAL
ī The injury may be due to inclusion of the soft
tissue such as the cervix or vaginal wall
inside the cup.