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Chapter 17 - Instrumental Delivery

from Part III - SURGICAL PROCEDURES

Published online by Cambridge University Press:  07 May 2010

John Patrick O'Grady ,
Martin L. Gimovsky ,
Lucy A. Bayer-Zwirello  and
Kevin Giordano
John Patrick O'Grady
Affiliation:
Tufts University, Massachusetts
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Summary

This chapter discusses instrument design, technique of application, and the risks and benefits of assisted delivery. The principal controversies concerning instrumental delivery by both forceps and the vacuum extractor are reviewed, and recommendations are made about the use of these instruments. The focus of this presentation remains the desirability and safety of instrumental delivery and a critical analysis of what constitute the best modern practice. Delivery instruments are conveniently classified into eight types: five of forceps, two of vacuum extractors, and one for miscellaneous instruments. The most important contraindications to vaginal delivery operations are operator inexperience and the inability to achieve a proper application. Educating clinicians in the appropriate use of force in instrumental deliveries is a difficult task. Instrument application involves forceps operation, and vacuum extraction. Maternal perineal lacerations are common complications of all operative vaginal deliveries; most are associated with episiotomy.

Keywords

cesarean deliveryepisiotomyforceps operationvacuum extractioninstrumental deliverymaternal perineal lacerations
Type
Chapter
Information
Operative Obstetrics , pp. 455 - 508
Publisher: Cambridge University Press
Print publication year: 2008

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