Obstetric operations are surgical procedures and
such irrespective of the nature of operation (major
or minor),asepsis and antiseptic precaution are to
be taken as outlined.
Even an internal examination during late
pregnancy and labour utmost asepsis. The
proximity of the bladder and rectum to the operative
field should deserve attention prior to any operative
The destructive operations are designed to
diminish the bulk of the fetus so as to
facilitate easy delivery through the birth
“It is an operation to make a perforation on the fetal
head, to evacuate the contents followed by
extraction of the fetus.”
1. Cephalic presentation producing obstructed labour
with dead fetus- this is the commonest indication
of craniotomy in the referral hospital of the
2. Hydrocephalus even in a living fetus- This is a
applicable both for the fore-coming and the after-
3. Interlocking head of twins
7. CONDITIONS TO BE FULFILLED :
1. The cervix must be fully dilated
2. Baby must be dead ( hydrocephalus being
I. The operation should not be done when the
pelvis in severely contracted so as to shorten
the true conjugate to less than 7.5 cm (3). In
such condition baby can not delivered, as the
bimastoid diameter( base of skull ) of 7.5 cm can
not be compressed.
II. Rupture of the uterus where laparotomy is
It is a destructive operation whereby the fetal head
is severed from the trunk and the delivery is
completed with the extraction of the trunk and that
of the decapitated head per vaginam.
1. Neglected shoulder presentation with dead fetus
where neck is easily accessible.
2. Interlocking head of twins.
“ The operation consists of removal of thoracic and
abdominal contents piecemeal through an opening
on the thoracic or abdominal cavity at the most
1. Neglected shoulder presentation with dead fetus;
the neck is not easily accessible
2. Fetal malformation, such as fetal ascites or
hugely distended bladder or monsters.
16. POST OPERATIVE CARE FOLLOWING
Exploration of the utero- vaginal canal must be
A self retaining (folley’s) catheter is put inside
Dextrose saline drip is to be continued
1. Injury to the utero-vaginal canal
2. Rupture of uterus
3. Postpartum hemorrhage , atonic or traumatic
4. Shock- due to blood loss and/or dehydration
5. Puerperal sepsis
6. Sub involution
7. Injury to the adjacent viscera-bladder– vesico-
vaginal fistula or rarely to rectal wall leading to
8. Prolonged ill health.