Instrumental delivery

Question 1

What is instrumental delivery?

Answer 1

• refers to vaginal delivery assisted by either a ventouse suction cup or forceps
• about 10% of births in the UK are assisted by an instrumental delivery
• procedure usually carried out on labour ward but if there are concerns then may be moved to theatre so c-section can be performed if necessary

Question 2

What is recommended to give after instrumental delivery?

Answer 2

-single dose of co-amoxiclav to reduce risk of maternal infection

Question 3

What are some indications for an instrumental delivery?

Answer 3

• failure to progress
• fetal distress
• maternal exhaustion
• control of the head in various fetal positions

*increased risk of requiring instrumental delivery when epidural is in place for analgesia

Question 4

What are the risks to the mother with an instrumental delivery?

Answer 4

• postpartum haemorrhage
• episiotomy
• perineal tears
• injury to the anal sphincter
• incontinence of the bladder or bowel
• nerve injury (obturator or femoral nerve)

Question 5

What are the risks to the baby with an instrumental delivery?

Answer 5

• cephalohaematoma with ventouse
• facial nerve palsy with forceps

Rare serious risks:

• subgaleal haemorrhage
• intracranial haemorrhage
• skull fracture
• spinal cord injury

Question 6

What is a ventouse?

Answer 6

• a suction cup on a cord that goes on baby’s head and doctor/midwife pulls on cord to pull baby out
• main complication is cephalohaematoma

Question 7

What is a forceps delivery?

Answer 7

• forceps are two pieces of curved metal that go either side of baby’s head, grip it so the doctor/midwife can pull out the baby
• main complication in facial nerve palsy
• also can leave bruises on baby’s face