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    Instruments & Indications

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    Ziyad
    The document discusses various obstetric and gynecological procedures and instruments including: 1. Forceps delivery and vacuum extraction which can be used to assist delivery but carry risks of traumatic injuries; 2. Ectopic pregnancy which occurs when a fertilized egg implants outside the uterus and can be treated surgically or medically; 3. Intrauterine devices which can be used for contraception but have potential complications like bleeding or expulsion; 4. Pelvic organ prolapse which involves descent of the pelvic organs and can be managed nonsurgically with pessaries or surgically with procedures like colporrhaphy or colpopexy.

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    Instruments & Indications

    Uploaded by

    Ziyad
    5K views11 pages
    The document discusses various obstetric and gynecological procedures and instruments including: 1. Forceps delivery and vacuum extraction which can be used to assist delivery but carry risks of traumatic injuries; 2. Ectopic pregnancy which occurs when a fertilized egg implants outside the uterus and can be treated surgically or medically; 3. Intrauterine devices which can be used for contraception but have potential complications like bleeding or expulsion; 4. Pelvic organ prolapse which involves descent of the pelvic organs and can be managed nonsurgically with pessaries or surgically with procedures like colporrhaphy or colpopexy.

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    ObGyn

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    The document discusses various obstetric and gynecological procedures and instruments including: 1. Forceps delivery and vacuum extraction which can be used to assist delivery but carry risks of traumatic injuries; 2. Ectopic pregnancy which occurs when a fertilized egg implants outside the uterus and can be treated surgically or medically; 3. Intrauterine devices which can be used for contraception but have potential complications like bleeding or expulsion; 4. Pelvic organ prolapse which involves descent of the pelvic organs and can be managed nonsurgically with pessaries or surgically with procedures like colporrhaphy or colpopexy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    5K views11 pages

    Instruments & Indications

    Uploaded by

    Ziyad
    The document discusses various obstetric and gynecological procedures and instruments including: 1. Forceps delivery and vacuum extraction which can be used to assist delivery but carry risks of traumatic injuries; 2. Ectopic pregnancy which occurs when a fertilized egg implants outside the uterus and can be treated surgically or medically; 3. Intrauterine devices which can be used for contraception but have potential complications like bleeding or expulsion; 4. Pelvic organ prolapse which involves descent of the pelvic organs and can be managed nonsurgically with pessaries or surgically with procedures like colporrhaphy or colpopexy.

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    You are on page 1of 11

    Indications

    1. Prolonged 2nd stage of labor.


    2. Shorten 2nd stage of labor for
    maternal benefit.
    3. Fetal Compromise.
    4. Stabilize head during breech.

    Kielland Forceps
    Prerequisites
    1. Fully dilated cervix, ruptured Simpson Forceps
    membrane and engaged head into
    pelvis.
    2. No doubt regarding position of
    fetal head.
    3. Adequate anesthesia.
    4. Empty bladder.

    Two Extra for vacuum:


    5. Pretem labor is contraindication.
    6. Face or breech presentation is
    contraindication.

    Vacuum Extraction
    Complications Forceps Complications Ventose
    1. Traumatic vaginal and uterine injuries. 1. Cephalohematomas.
    2. Trauma to maternal anal sphincter. 2. Subgaleal hematoma
    3. Facial Palsy. 3. Scalp bruising and lacerations
    4. Fetal Skull fracture 4. Maternal perineal lacerations
    Symptoms
    1. Lower abdominal pain
    2. Amnenorrhea followed by
    vaginal bleeding

    Risk factors for ectopic pregnancy


    1. History of STD or PID
    2. Prior ectopic pregnancy
    3. Previous Tubal Surgery
    4. Endometriosis
    5. IVF and ART
    6. IUD

    Surgical Rx
    1. Exploratory laproscopy
    2. Salpingostomy
    3. Salpingectomy
    4. Cornual Resection

    Medical Rx
    1. Methotrexate
    Maternal Complications
    1. Anemia
    2. Hydramnois
    3. Hypertension
    4. PPH
    5. Preecalmpsia
    6. C/S

    Fetal Complications
    1. Malpresentation
    2. Placenta previa
    3. PROM
    4. IUGR
    5. Prematurity.
    6. Umbilical cord prolapse
    7. Increase perinatal M&M
    Indications
    1. Contraception.
    2. Dysmenorrhia.
    3. Menorrhagia.

    Contraindications
    1. Active cervical infection.
    2. Cervical cancer
    3. Distortion of uterine cavity
    4. Uterine cavity that is not correct size.

    Complications
    1. Unscheduled bleeding
    2. Spotting in early months
    3. Expulsion
    4. Uterine perforation during insertion.
    5. Ectopic pregnancy
    Indications
    1. Uterine Prolapse
    2. Vaginal Prolapse
    3. Stress urinary incontinence

    Risk factors of prolapse


    1. Postmenopausal (2nd to decrease
    estrogen).
    2. Multiparity and traumatic delivery.
    3. Caucasian (ethnicity) Hodge (Ring) Pessary
    4. Hysterectomy and pelvic surgery
    5. Connective tissue defect

    Symptoms
    1. Low back pain
    2. Urinary urge incontinence
    3. Sensation of bulging
    4. Constipation
    Diagnosis
    Single-blade speculum examination
    asking the patient to strain down.

    Staging
    Hymen plane is defined as zero
    0 No prolapse (-3 cm)
    1 Above hymen (-1)
    2 Level of hymen (-1 to +1)
    3 Beyond hymen (> +1)
    4 Complete eversion

    Complete Procidentia
     Uterine prolapse through vaginal hymen represents failure of all
    the vaginal supports.
     Complications: excessive purulent discharge, decubitus ulcers,
    bleeding, and rarely carcinoma of the cervix.

    Managements
    1) Nonsurgical: Kegel excersise and pessaries (unfit or refusing
    surgery, during pregnancy, post-partum)
    2) Surgical: Anterior and posterior colporrhaphy (cystocele &
    enterocele), colpopexy (apical prolapse)
    Elective C/S
    1. Previous classical C/S
    2. Placenta previa.
    3. Active herpes.
    4. HIV
    5. Breech .
    6. Twins not in cephalic-
    cephalic or more than three
    fetuses

    Emergency C/S
    1. Dystocia
    2. Fetal distress
    3. Cord prolapse
    4. Uterine rupture

    Complication C/S
    1. Hemorrhage
    2. Fetal injury
    3. Injury to surrounding organs
    4. Blood clots.
    5. Increase risk during future pregnancies.
    Uses
    1. Monitor fetal heart rate.
    2. Repetitive decels.
    3. Difficult external trace (obesity)
    4. Twins
    Contraindications
    1. Hepatitis or HIV
    2. Fetal thrombocytopenia

    Indication for AROM Fetal scalp electrode (FSE)


    1. PET, DM, Heart disease.
    2. Prolonged pregnancy
    3. IUGR
    4. Chorioamnionities

    Complication of Oxytocin for Ind. & Aug.


    1. Hyperstimulation (excessive infusion) possible rupture of uterus
    and fetal distress.
    2. Severe water intoxication with convulsions (antidiuretic effect). Amnihook
    3. Post-delivery uterine atony.
    Uses
    Gyn:
    1. Pap smear
    2. Endometrial biopsy
    3. Prolapse

    Obstetrics:
    4. D&C
    5. Abortion
    Devilbiss Speculum Cusco Speculum
    6. Hystrectomy

    Complications
    1. Vaginal laceration
    2. Urethral damage
    3. Patient discomfort

    Graves Speculum Sims Speculum


    Curette
    Doytens Retractor
    Hegar’s Cervical Dilators

    Tenacullum
    Cervical Spatula and Cytobrush

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