Operative vaginal delivery Flashcards
What are the indications for an operative delivery?
fetal compromise, maternal exhaustion, prolonged second stage
What is the definition of prolonged second stage for a nulip with an epidural?
> 3 hrs without progress
What is the definition of prolonged second stage for a nulip without an epidural?
> 2 hrs without progress
What is the definition of prolonged second stage for a multip with an epidural?
> 2 hrs without progress
What is the definition of prolonged second stage for a multip without an epidural?
> 1 hr without progress
What are the contraindications to both a vaccuum and forceps delivery?
< 10 cm dilated, above 0 station, breech, brow or face presentation, unknown position of fetal head, suspected cephalopelvic disproportion, fetal osteogenesis imperfecta, concern for thrombocytopenia, hemophilia
What gestational age is contraindicated for a vacuum delivery?
< 34 wga
What fetal weight is a relative contraindication for a vacuum?
< 2500 grams
What requirements must be met in the mom for a safe vacuum delivery?
adequate anesthesia, empty bladder, full dilation adequate maternal pelvis
What are the recommended number of pulls when using a vaccuum?
3
What is the maximum recommended number of time that the vaccum should be applied?
15 - 20 minutes
What is the maximum number of pop offs allowed
3
What is the main risks with more than 3 vacuum pop offs?
Neonatal trauma, NICU admissions
What are the criteria for outlet forceps?
Scalp visible at introitus without separating labia, AP position, rotation < 45 degrees
What are the criteria for low outlet forceps?
Leading bony point > +2 station but not at perineum/pelvic floor
