Operative vaginal delivery

Question 1

What are maternal indications?

Answer 1

1. Prolonged 2nd stage for any reason
2. Exhaustion
3. Medical avoidance of pushing e.g. severe cardiac disease
4. Pushing not poss. - tetraplegia

Question 2

What are fetal indications?

Answer 2

suspected fetal distress

for the after-coming head in a breech delivery

Question 3

What are the main types

Answer 3

forceps

ventouse

Question 4

which type is more successful

Answer 4

forceps

Question 5

which type is safer for the baby

Answer 5

forceps

Question 6

which type is more likely to cause genital tract trauma?

Answer 6

forceps

Question 7

which type causes chignon?

Answer 7

ventouse

Question 8

what are injuries to the fetus w forceps?

Answer 8

facial nerve palsy
skull fractures
orbital injury
intracranial haemorrhage

Question 9

what are injuries to the fetus w ventouse?

Answer 9

cephalohaematoma
retinal haemorrhage
scalp lacerations and avulsions

Question 10

when should instrumental delivery be abandoned

Answer 10

1. no descent w each subsequent pull

2. delivery not imminent after 3 pulls

Question 11

What is management of all instrumental deliveries and why?

Answer 11

vitamin k to prevent vitamin K deficiency bleeding