instrumental delivery

Question 1

what is recommended after instrumental delivery

Answer 1

single dose of co-amoxiclav

–> reduce risk of maternal infection

Question 2

indications

Answer 2

failure to progress
fetal distress
maternal exhaustion
control of head

Question 3

when is there increased risk of requiring instrumental delivery

Answer 3

epidural in place for analgesia

Question 4

risks to mum

Answer 4

PPH 
episiotomy 
perineal tears
anal sphincter damage
incontinence bladder or bowel
nerve injury - obturator or femoral

Question 5

risks to baby - ventouse

Answer 5

cephalohaematoma

Question 6

risks to baby - forceps

Answer 6

facial nerve palsy

Question 7

ventouse

Answer 7

suction cup on a cord

Question 8

ventouse - main complication

Answer 8

cephallohaematomy - collection of blood between skull and periosteum

Question 9

forceps

Answer 9

big tongs

2 peices of metal curved to go on either side baby’s head

Question 10

forceps - main complication

Answer 10

facial nerve palsy

Question 11

nerve injuies

Answer 11

instrumental delivery can results in nerve injury to mum

usually resolves 6-8wks

femoral or obturator nerve

Question 12

nerve injuies - femoral

Answer 12

can be compressed against inguinal canal during forceps delivery

Question 13

nerve injuies - femoral - clinical

Answer 13

weakness knee extension
loss patella reflex
numbness anterior thigh

Question 14

nerve injuries - obturator - clinical

Answer 14

weakness hip adduction and rotation

numbness medial thigh

Question 15

nerve injuries that can occur during birth - unreleated to instrumental delivery

Answer 15

lateral cutaneous nerve thigh
lumbosacral plecus
common proneal nerve

Question 16

Lateral cutaneous nerve of the thigh - injury

Answer 16

numbness anterolateral thigh

Question 17

Common peroneal nerve - injury

Answer 17

foot drop

numbness lateral lower leg