Instrumental Delivery

Question 1

what is the purpose of an instrumental delivery?

Answer 1

allows the use of traction if delivery needs to be expedited during the 2nd stage of labour to prevent fetal and maternal mobidity

Question 2

what are the common indications for instrumental delivery?

Answer 2

• prolonged active 2nd stage (failure to progress)
• maternal exhaustion
• fetal distress
• breech presentation
• prophylactic use in medical conditions e.g. cardiovascular disease, HTN
• can be used to rotate a malpositioned fetal head

Question 3

what are the requirements for instrumental delivery? – FORCEPS mnemonic

Answer 3

F - Fully dilated cervix, generally 2nd stage of labour must have been reached

O - OA position preferably, OP delivery possible with Keillands forceps and ventouse. Position of head must be known as incorrect placement of forceps/ventouse could lead to maternal/fetal trauma and failure

R - Ruptured membranes

C - Cephalic presentation

E - Engaged presenting part i.e. head at or below ischial spines; head must not be palpable abdominally

P - Pain relief

S - Sphincter (bladder) empty; catheterisation