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Chapter 2 - Indications and assessment for operative vaginal birth

Published online by Cambridge University Press:  05 June 2014

George Attilakos
Affiliation:
University College Hospital, London
Tim Draycott
Affiliation:
University of Bristol
Alison Gale
Affiliation:
Lancashire Teaching Hospitals NHS Trust
Dimitrios Siassakos
Affiliation:
University of Bristol
Cathy Winter
Affiliation:
Practical Obstetric Multi-Professional Training (PROMPT) Maternity Foundation
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Summary

Operative vaginal births (OVB) have an important role to play in modern obstetric care. OVB should be offered only when the benefits outweigh the potential risks, taking account of both maternal and neonatal perspectives. A systematic clinical assessment, effective communication and expertise in the intended procedure are prerequisites for OVB. OVBs are classified primarily by the station and position of the fetal head. OVB are performed when birth needs to be expedited and may be indicated for conditions of the fetus or the mother or both. Suspected fetal compromise, as revealed by a suspicious or pathological fetal heart rate pattern on cardiotocography (CTG), is also a common indication for OVB. Careful patient assessment, observing the rules of safe obstetric practice and working within the appropriate clinical indications for OVBs should ensure that the benefits of recommending OVB outweigh the risks.
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Publisher: Cambridge University Press
Print publication year: 2013

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