aSSISTED vAGINAL DELIVERY

D ef B o ut
Delivery of baby vaginally using an instrument for assistance

VACUUM/ VENTOUSE
Priority more than forceps less likely to cause vaginal tearing

FORCEPS
Less used bcoz can injured mom

Metal cup

Soft cup
Suck kurang sket preferred for use when : baby's head is low in the woman's birth canal the baby will come down relatively easily

Low
Outlet fetal head has reached the perineal floor and visible at the vulva Usually use in C-sec

Mid
Engageme nt has taken place and the leading part of the head is below the level of ischial spine
ANDERSONS (SIMPSONS) FORCEPS

High
Application when the head is not engaged Abandoned in favour of Caesarean Section
KIELLANDS FORCEPS

euqinhceT uisitesPrereq

Suck lagi kuat allow correct placement over the occiput when the head is deflexed head is higher in the birth canal

WRIGLEYS FORCEPS Dilatation (min 8cm)of cervix & full engagement of head Co-operation from ptx Good contraction should present

Suitable for mid forceps Designed delivery for use when with the head is sagittal at the sutures of perineum & the head in LA is being the antero used posterior axis

Designed to deliver fetal head at or above the pelvic brim lying in transverse axis of pelvis & rotating it when it has reached the pelvic cavity

Delivery should completed within 15 mins of application Head not just scalp should descend w each pull Cup should reapplied no more than twice Failure w correctly placed ventouse forceps x yah try ok Delay in 2nd stage Fetal distress Maternal condition requiring short 2nd stage Face presentation Gestation b4 34 wks Marked active bleeding from fetal blood sampling site High fetal position above 0 W good technique Baby : risk is small dev chignon Mommy: (oedematous Commonest : skin bump) trauma to genital cephalhaemato tract ma Unrecognized injury (subperiosteal bleed) of cervix serious haemorrhage

Rules

Only traction

Traction (sometim es ada rotation)

Traction & rotation

Face presentation Bleeding from fetal blood sampling site After-coming head of breech Delivery before 34 wks gestation Head not fully engaged Cervix not fully dilated Mommy: Danger of GA Laceration of cervix, vagina or perineum PPH Puerperal genital infection

C/I

Indicati on

Baby : Intracranial hemorrhage Facial nerve palsy Cephalhaematoma

Cx

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