Operative delivery

Question 1

3 names of forceps , one suction technique

Answer 1

Neville barnes/simpsons/ haigh fergusons
keillands
wrigleys

Ventouse (KIWI)

Question 2

5 'steps' of consent 
C
D
U
V
A

Answer 2

Competance 
disclosure 
understanding
voluntariness 
authoristation

Question 3

% of how many deliveries are forceps

Answer 3

10-13

Question 4

3 types of forceps delivery

Answer 4

1. non-rotational forceps : Neville barnes, simpsons, wrigleys
2. Rotational Keillands forceps (reduced pelvic curve allows rotation)
3. suction, both non rotational and rotational

Question 5

Maternal indications for forceps

Answer 5

Inadequate progress in 2ND STAGE of labour
Maternal exhaustion
Prophylactic shortening of the second stage

Question 6

Fetal indications for forceps

Answer 6

Suspected fetal compromise in 2ND STAGE

eg. pathological CTG or abnormal

Question 7

in what fetal positions are direct forceps used / are the rest rotational ?

Answer 7

LOA OA ROA = non rotation

all the rest (transverse and Posterior)= rotation

Question 8

Name some complications of forceps delivery

Answer 8

PPH
Perineal tears
Fetal bruising and chignon
Shoulder dystocia

Question 9

% of deliveries being CS

Answer 9

24

Question 10

after what week is elective LSCS carried out ?

1-4 categories of emergency LSCS and times baby should be delivered by

Answer 10

39 weeks

1. immediate threat to life of woman or fetus = <30mins
2. Maternal / fetal compromise that is not immediately life threatening = <75mins
3. No M/F compromise but needs early delivery= Hours
4. Delivery time to suit woman and staff = days

Question 11

Name some indications for an elective LSCS

Answer 11

• fetal position (breech)
• previous LSCS
• some twins / triplets
• placental problems
• maternal infection

Question 12

Maternal indications for LSCS

Answer 12

PET / active primary herpes

Question 13

Fetal indications for LSCS

Answer 13

suspected fetal compromise in ANY STAGE of labour

fetal disease

Question 14

Name some risks of LSCS to mother

Answer 14

• increased risk of repeat CS
• readmission to hospital
• haemorrhage
• infection
• Emergency hysterectomy
• need for further surgery
• bladder and ureteric surgery
• death

Question 15

fetal risks of LSCS

Answer 15

• fetal injury lacerations

- admissions to intensive care unit

Question 16

Evidence for having to repeat in future pregnancies?

Answer 16

forceps : no evidence for repeating

LSCS : risk of uterine rupture in next VBAC… think about IOL.
VBAC success rate of 85-90%
needs continuous electronic fetal monitoring