14 - Obs - Instrumental + Operative Delivery - Forceps + Ventouse

Question 1

Aim - prevent ? and ? morbidity ass w ? ? stage, or expedite delivery where fetus is ?

Answer 1

maternal
fetal
prolonged 2nd stage
compromised

Question 2

Complications - maternal
Need for analgesia greater w ?, but use of either can cause vaginal ?, ? loss or ? degree tears. Cervical and uterine tears v ?.

Answer 2

forceps
laceration
blood
3rd
rare

Question 3

Complications - fetal
Slightly worse w ?.
Chignon – area of ? sucked by ?, diminishes over hours, mark may be visible for ?. ?
lacerations, ? and neonatal ? more common w ?. ? bruising, facial ? damage and even skull/neck ? occasionally occur. ? traction by either is dangerous.

Answer 3

ventouse
scalp
cup
days
scalp
cephalohematoma
jaundice
ventouse
Facial
nerve
fractures
prolonged

Question 4

3 common indications for instrumental delivery + one more

Answer 4

prolonged active second stage (>1h)
maternal exhaustion
fetal distress in second stage
maternal pushing CI’d

Question 5

3 things predisposing to instrumental delivery

Answer 5

CTG, induction, epidural

Question 6

Prerequisites for instrumental delivery

• ? not palpable ?
• head at/below ? ? on VE
• cervix ? dilated
• ? of head is known
• adequate ?
• ? empty
• valid indication for delivery

Answer 6

head - abdominally
ischial spines
fully
position
analgesia
bladder

Question 7

Ventouse causes ? failure rate, more fetal ?, no difference in ? scores, ? maternal trauma

Answer 7

higher
trauma
apgar
less

Question 8

percent of nulliparous women req instruments?

percent of multiparous women req instruments?

Answer 8

20%

2%