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24 Cards in this Set
- Front
- Back
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What is considered PROLONGED 2ND STAGE in a Nulliparous woman with or without anesthetic?
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With: 3 hrs
Without: 2 hrs |
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What is considered PROLONGED 2ND STAGE in a Multiparous woman with or without anesthetic?
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With: 2 hrs
Without: 1 hr |
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Requirements for Instrument delivery:
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-Vertex
-Cervix completely dilated -ROM -No known CPD -willing to abandon |
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Where does the fetal head HAVE to be do do instrument delivery?
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ENGAGED - the biparietal diameter passing thru the pelvic inlet at/below the ischial spines
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What are the 3 classes of assisted deliveries?
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OUTLET forceps/vacuum
LOW forceps/vacuum MID forceps/vacuum |
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What is the A in ABCDEFGHI for VACUUM?
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A-ask for help, address patient, adequete anesthesia
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B
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Bladder - full/drained?
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C
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cervix - is it completely dilated?
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D
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Determine the Position
Dystocia - remember HELPERR? |
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E
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Equipment ready?
Evacuator? |
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F
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Place cup in proper relation to the Fontanells at the Flexion point
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G
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Gentle traction - perpendicular to the plane of the cup
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H
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Halt after
-3 pop offs -3 unsuccessful ctx/pulls -20min of no progression |
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I
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Incision - if episiotomy needed when head crowning
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J
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When Jaw is reachable remove the vacuum
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What are the disadvantages of the vacuum compared to the forceps?
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More cephalohematomas, more failed attempts
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What is extremely important to remember AFTER using a vacuum?
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-Examine the cervix/vagina
-Look for evidence of birth trauma |
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What should you do after post-vacuum care?
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Write a vacuum operative note
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What is the first difference in the Forceps ABCDEFGHIJ algorithm?
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F - forceps ready at the PFS
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What is PFS?
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Posterior fontanelle
Fenestrations Sagitall suture |
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What is G in the forceps acronym?
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Gentle traction initially downard then in a large J-shaped arc using Pajot's maneuver
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What is H?
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Handle elevated to follow the J of pajot's maneuver
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Do you ever have to halt in a forceps delivery?
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nope!
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What are I and J?
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Evaluate for Incision
Remove forceps when you see the Jaw |
