Operative Delivery Flashcards
What are indications for a vaginal operative delivery?
Fetal compromise - Via fetal scalp sample
Maternal complications - anything limiting pushing eg CVD, spinal concerns, myasthenia gravis
Inadequate progress - Fully dilated but not engaged, exhausted
What are the requirements for an operative vaginal delivery?
C - Cervix fully dilated
A - Analgesia
B - Empty bladder
PLUS
Ready for C section
Head not palpable in abdomen and below ischial spines
What are the two methods?
Ventouse
Obstetric forceps - Neville Barnes of Keilland
How do you apply a ventouse?
2/3cm anterior to posterior fontanelle
What are the two obstetric forceps?
When are they used?
How are they used
Neville barnes - for when head is occipate anterior as cant rotate. Pull with contractions
Keilland - for all other positions, pull and rotate between contractions
Which one is more harmful to the mother?
Forceps
When one is less likely to succeed? What else is it?
Vontouse
Also can cause scalp bleeding and maternal distress at appearence
What are the two types of C-section?
Elective - 39 weeks
Emergency
What are the indications for C-section?
Severe pre eclampsia/eclampsia
Pelvic deformties
Placenta previa
GDM
Fetal distress
Breech
Classical Caesarian scar
Severe IUGR
What are the complications of a C-section?
Infection
Haemorrhage
Thromboembolism
What week do you attempt to get to in severe pre eclampsia/eclampsia or severe IUGR?
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