L3: Ventouse Flashcards
Def of Ventouse
- Instrument that applies traction on fetal head by a cup applied to fetal scalp (by creating -ve pressure → edema of scalp “Chignon” on which cup is adapted).
History of Ventouse
- Original Malmstrom instruments (1956-1967) consist of vacuum bottle, metal cup & hand pump however, recently, vacuum extractors with malleable silicon cup & electric pump have become popular.
Composition of Ventouse
Composition of Ventouse
- Suction Cup
Suction Cup
- Size
- 2 cm in depth with different diameters (3, 4, 5 or 6 cm).
Suction Cup
- Material
Metal Suction Cup
- Uses
- large baby
- large caput
- if difficult delivery is anticipated.
Silicon Rubber Suction Cup
- Uses
- Associated with less scalp lacerations so, it is used in majority of situations however, it isn’t advisable in case of excessive caput.
Suction Cup
- Knob
Modern cup is provided with knob that indicates position of occiput in pelvis during rotation.
Composition of Ventouse
- Suction Pump
- May be electric or manual & it generates -ve pressure that is conducted to cup by rubber tubing.
Composition of Ventouse
- Vacuum Bottle
- Has 3 outlets (for tube of cup, suction pump & manometer graduated to 1 kg/cm2).
Composition of Ventouse
- Traction Piece
- Formed of traction plate, traction chain & traction handle.
Parts of Ventouse (IMAGE)
Indications of Ventouse
CI of Ventouse
Prerequisities of Ventouse
Technique of Ventouse
Advantages of Ventouse
Complications of Ventouse
Complications of Ventouse
- Maternal
Complications of Ventouse
- Fetal
Def of Failed Ventouse
Failure of delivery of fetus with 3 pulls within 15 minutes from start of the procedure.
Causes of Failed Ventouse
Causes of Failed Ventouse
- Maternal
Contracted pelvis.
Poor maternal effort.
Causes of Failed Ventouse
- Fetal Factors
- Misdiagnosed position & attitude of head.
- CPD.
- High head.
Causes of Failed Ventouse
- iatrogenic
- Failure to use proper instrument (silicone rubber cup fails with deflexion, excessive caput, large baby & prolonged 2nd stage).
- Anterior or lateral placement of cup.
- Traction in wrong direction.
Management of Failed Ventouse