Operative Obstetrics Flashcards
Blade for rounded head
Multiparas
Tucker Mac Lane
Blade for molded head
Nulliparous
Simpson
Deep transverse arrest of the head
Kielland
Leading pt of the fetal skull is at station +2
Rotation greater than 45 degrees
Low forceps
Scalp is visible at introitus Skull at pelvic floor Head is at perineum Rotation does not exceed 45 degrees Sagittal suture is in the AP diameter
Outlet forceps
Fetal head is engaged but has not reached +2 yet
Mid forceps
Maternal indications most impt
Heart disease
Pre requisites for forceps application
Engaged Vertex or chin anterior Position known Dilated cervix Ruptured membranes No CPD
CI forceps
No proper indication Incompletely dilated cervix Marked CPD Unengaged fetal head Lack of experience
Vacuum extraction technique
3 cm over sagittal suture
CS Incisions
Abdominal
Infraumbilical mid vertical
Transverse suprapubic (pfannenstiel) transverse skin and subcutaneous
Maylard transverse rectus muscle
CS Incisions
Uterine
Classical vertical on uterine body
Transverse Kerr CHOICE transverse at LUS
Kronig vertical at LUS
Indications for Classical CS
Unavailable LUS
Ant implanted placenta previa
Neglected transverse lie
Massive maternal obesity
MCC PP hysterectomy
Placenta accreta
VBAC candidates
Prior low transverse uterine incision
Clinically adequate pelvis
No other uterine scars or previous history of rupture
Emergency CS
