Operative Delivery

Question 1

The following has not been shown to decrease the rate of operative delivery.

a) Delayed pushing (passive descent) in 2nd stage.
b) One to one labour support
c) Oxytocin augmentation.
d) Avoidance of epidural anaesthesia.
e) Use of a cartogram during labour

Answer 1

b

Question 2

Which of the following is not true?

a) maternal laceration risk higher with forceps than vacuum
b) manual rotation has been shown to increase the risk of maternal trauma with operative delivery
c) vacuum is more likely than forceps to fail
d) cephalohematoma and retinal hemorrhage is more common in vacuum than in forceps deliveries

Answer 2

b

Question 3

Name contraindications to Operative Vaginal Delivery (5):

Answer 3

1. non-vertex or brow presentation
2. unengaged head
3. incomplete dilatation (unless you are MLM)
4. clinical evidence of cephalopelvic disproportion
5. fetal coagulopathy
6. fetal prematurity (<34 weeks for vacuum)

Question 4

What are the prerequisites to operative delivery?

Answer 4

1. vertex presentation
2. cervix fully dilated and membranes ruptured
3. head fully engaged
4. exact position known so instrument can be applied correctly
5. adequate pelvis
6. informed consent
7. appropriate analgesia
8. bladder emptied
9. adequate facilities and backup plan available
10. skilled operator

Question 5

Complications of vacuum:

Answer 5

1. cephalohematoma
2. retinal hemorrhage
3. intracranial hemorrhage
4. maternal laceration
5. hyperbilirubinemia
   6.

Question 6

Complications of Forceps:

Answer 6

1. cephalohematoma
2. external ocular trauma
3. facial nerve injury
4. maternal laceration
5. hyperbilirubinemia
6. intracranial hemorrhage