C-section and instrumental delivery

Question 1

Forceps and Ventouse indications and prerequisites

Answer 1

Indications: prolonged 2nd stage; fetal distress in 2nd stage; maternal pushing contraindicated
Prerequisites: cervix fully dilated; position of head know; head deeply engaged and mid-cavity or below; adequate analgesia; empty bladder; valid indication

Question 2

Forceps and Ventouse complications

Answer 2

Maternal: lacerations, haemorrhage, third-degree tears
Fetal: lacerations, bruising, facial nerve injury

Question 3

C-section indications

Answer 3

Emergency: failure to advance; fetal distress; abruption; cord prolapse;antepartum haemorrhage; pre-eclampsia
Elective:
Fetal: malpresentation; placenta praevia; macrosomia; SGA
Maternal: comorbidity; previous LSCS; previous traumatic vaginal birth; previous shoulder dystocia; maternal infections

Question 4

C-section complications

Answer 4

Haemorrhage; uterine/wound sepsis; thromboembolism; anaesthetic; subsequent pregnancy problems; damage to bowel/bladder/urethra