Instrumental Delivery Flashcards
What are the 2 types of instrumental delivery?
- Forceps (low/mid-cavity)
2. Ventouse (kiwi, silicone rubber cup, metal cup)
What are some indications for instrumental delivery?
- Delayed/prolonged in 2nd stage
- Malposition
- Foetal distress
- Multiple birth
- Maternal request
What are some contraindications for instrumental delivery?
- Unengaged head
- Malpresentation
- LGA
- Inexperienced operator
- <36/40 (ventouse)
- Not fully dilated
Which is the preferred instrument?
- Emergency = forceps is preferred as ventouse suction takes time to build up and may slip off
- Non-emergency = whatever the practitioner is more skilled with
What position should the mother be in?
Lithotomy
What are some neonatal complications of ventouse delivery?
- Haematoma
- Scalp abrasions
- Retinal haemorrhage
What are some maternal complications of ventouse delivery?
- Trauma
- PPH
- Failure to deliver baby
Which instrument causes a higher risk of PPH?
Forceps
Which instrument has the worse neonatal outcomes?
Ventouse
What are some neonatal complications of forceps delivery?
- Marks/bruising on face
- Facial palsy
What are some maternal complications of forceps delivery?
- Soft tissue injuries
- Damage to urethra
- PPH
When should a Caesarean section be performed?
If delivery is not imminent after 3 successful tractions
When should an episiotomy be performed?
- Only when the head is crowning
- Always for forceps, only when necessary for ventouse
