operative delivery

Question 1

forceps vs vaccum

Answer 1

more failed deliveries, intracranial hemorrhages, hematoma, and scalp lacerations with vaccum , but fewer perineal injuries with vaccum

Question 2

prerequisites for operative vaginal delivery

Answer 2

• must have analgesia (for forceps only)
• empty bladder
• vertex presentation
• engaged fetal head
• station > +2
• FULLY DILATED
• no placenta previa
• ruptured membranes

Question 3

what are the two categories of operative delivery

Answer 3

1. vaginal (forceps or vacuum)

2. C-section

Question 4

keiland forceps vs piper forceps

Answer 4

keiland = rotational for malpresentation of head (transverse) 
piper = for breech babies

Question 5

fetal and other indications for operative vaginal delivery

Answer 5

1. non-reassuring fetal status (bradycardia, decelerations)

2. prolonged second stage of labor (i.e must be fully dilated at this point) - primi >2-3 hrs , multi >1-2 hrs

Question 6

where do you place the vaccum for a vaginal delivery

Answer 6

fetal head with the pump 2cm anterior to the posterior fontanelle and centered over the sagittal suture
*vaccum port should point towards the occiput

Question 7

indications for c-section

Answer 7

• breech/ transverse
• IUGR < 1500 gms
• herpes
• CPD
• placental previa
• maybe placental abruption

Question 8

__ increases the risks of uterine atony and PPH

Answer 8

c-section

Question 9

maternal indications for operative vaginal delivery

Answer 9

1. mom too tired to push/ can’t push (spinal cord injury)

2. cardiac pt avoid stress (AORTIC STENOSIS, aneursym)