Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (20)
Similar to Ventose and forceps delivery for undergraduate
Similar to Ventose and forceps delivery for undergraduate (20)
More from Faculty of Medicine,Zagazig University,EGYPT
More from Faculty of Medicine,Zagazig University,EGYPT (20)
Recently uploaded
Recently uploaded (20)
Ventose and forceps delivery for undergraduate
- 1. Ventose and Forceps deliveryVentose and Forceps delivery Dr Manal Behery Porofessor of Obstetricis &Gynecology Zagazig University 2014
- 3. IndicationsIndications MATERNAL Exhaustion Prolonged second stage Cardiac / pulmonary disease FETAL Failure of the fetal head to rotate Fetal distress Should not be used for preterm, face presentation or breech
- 4. MNEMONICMNEMONIC A – Anesthesia adequate appropriate positioning & access B – Bladder cathterization C – Cervix fully dilated / membranes ruptured D – Determine position, station, pelvic adequacy
- 5. E – Equipment inspect vacuum cup, pump, tubing, check pressure
- 6. F – Fontanelle position the cup over the posterior fontan -ve pressure ↑ 10 cm H2O initially & between cont sweep finger around cup to clear maternal tissue ↑ pressure to 60 cm H2O with the next contraction
- 7. G – Gentle traction pull with contractions only traction in the axis of the births canal ask the mother to push during cont
- 8. H – Halt halt traction if no progress with three traction aided contractions vacuum pops off three times pulling for 30 min without significant progress
- 9. I – Incision consider episiotomy if laceration imminent J – Jaw remove vacuum when jaw is reachable or delivery assured
- 10. Steps of ventose applicationSteps of ventose application
- 11. 11
- 12. ComplicationsComplications Vacuum –assisted delivery is less traumatic to the mother & fetus than forceps Ventouse should be the instrument of choice Maternal Vaginal laceration due to entrapment of vaginal mucosa between suction cup & fetal head
- 13. Fetal complicationsFetal complications Scalp injuries chignon abrasion & lacerations 12.6% scalp necrosis 0.25-1.8% Cephalohematoma 25% jaundice /anemia Intracranial hemorrhage 2.5% Subgaleal hematoma
- 14. Fetal complicationsFetal complications Birth asphyxia 2.6-12% related to extraction force & time Some studies showed decrease birth asphyxia Retinal hemorrhage 50% Forceps 31% SVD 19% Neonatal jaundice
- 15. FORCEPSFORCEPS
- 16. IndicationsIndications MATERNAL Exhaustion Prolonged second stage Cardiac / pulmonary disease FETAL Failure of the fetal head to rotate Fetal distress Control of the fetal head in vaginal beech delivery
- 17. Classification of forceps deliveryClassification of forceps delivery Outlet forceps Scalp visible at the vulva without separating the labia Low forceps Vertex at +2 station Midforceps Head is engaged but leading part above +2 station Sagittal suture not in the AP plane of the mother
- 18. Classification Of Forceps DeliveryClassification Of Forceps Delivery Outlet Wrigley’s Outlet & low forceps Simpson /Elliot Midforceps & outlet Tucker Mclane Midforceps & rotation Kielland After coming head in breech Piper
- 19. After coming head in breechAfter coming head in breech PiperPiper
- 20. MNEMONICMNEMONIC A – Anesthesia adequate /epidural or pudendal appropriate positioning & access B – Bladder cathterization C – Cervix fully dilated / membranes ruptured D – Determine position, station, pelvic adequacy E – Equipment complete working forceps anesthesia support
- 21. F – Forceps phantom application Lt blade , LT hand, maternal Lt side pencil grip & vertical insertion with Rt thumb directing blade Rt blade , RT hand, maternal Rt side pencil grip & vertical insertion with Lt thumb directing blade Lock blades
- 22. Check application: Post fontanelle 1cm above the plane of the shanks Sagittal suture lies in the midline of the shanks /perpindicular to the plane of the shanks The operator can not place more than a fingertip between the fenestration of the blade & the fetal head on either side
- 23. G – Gentle traction applied with contraction & maternal expulsive efforts H – Handle elevated traction in the axis of the birth canal do not elevate handle to early
- 24. I – Incision consider episiotomy if laceration imminent J – Jaw remove forceps when jaw is reachable or delivery assured
- 25. ComplicationsComplications Maternal trauma to soft tissue 3rd /4th degree double the risk compared to ventouse bleeding from lacerations trauma to urethra & bladder fistula Pain 17% ventouse 11%
- 26. ComplicationsComplications Fetal bruising & laceration to the face Injury to the fetal scalp cephalohematoma 9% Vent 25% retinal hemorrhage 30% Vent 50% skull fracture permanent nerve damage / Facial nerve
Editor's Notes
- Instrumental deliveries 1-Indications for instrumental deliveries include T1-Prolonged 2nd stage T2-Fetal distress F3-Transverse lie F4-Compound presentation T5-Maternal cardiac disease
- 2-Prerequisite for instrumental delivery include T1-Cervix must be fully dilated T2-Membranes ruptured F3-Fetal head not engaged F4-Obstetrician unsure about position of the fetal head due to caput T5- Bladder empty/ cathetrized
- 3-Complications of ventouse delivery F1-Ventouse causes 3rd & 4th degree perineal tears more frequent than forceps F2-Long term effects on neurological & intellectual development of children delivered by ventouse are evident by 4 years of age T3-Cephalohematoma occur in up to 25% of babies T4-Birth asphyxia is related to the force of traction & prolonged procedure (time from application of vacuum until delivery) T5-Cephalohematomas may result in jaundice & anemia of the neoborne
- 4-Forceps T1-can be applied to the after coming head in assisted vaginal breech delivery T2-Can be applied to face presentation T3-It is not contraindicated for preterm fetuses T4-Can result in facial nerve damage of the fetus T5-Is associated with a higher fetal mortality than ventouse