Choice of instruments forcepsventouse

Different forceps and vacuum devices are used for IVD. The choice of forceps or vacuum instrument should depend on the operators experience, station and position of the vertex. Hence the assessment of the station and the position of the vertex are of great importance. For occipito-anterior positions in the mid- or low cavity or low direct occipito-posterior positions (to deliver as face to pubis) the Neville Barnes with or without axis traction handle or the Simpson's forceps can be used. Wrigley's forceps is ideal for outlet deliveries. If the position is occipito-lateral or posterior a Keilland's forceps is needed to achieve rotation without inflicting trauma to the fetus or the maternal passages. Vacuum devices such as silk, silastic or metal cup with the suction tubing arising from the dorsum of the cup, that is, anterior cup can be used for an occipito-anterior position. A posterior metal cup or rigid plastic cup with the suction tubing coming to the lateral side of the cup is needed for an occipito-posterior or lateral position so that the cup can be manipulated between the head and

Occiput Posterior Delivery
Fig. 24.9 Biparietal-bimalar application offers uniform grip on the two sides. The sagittal suture bisects the shank which is over the flexion point - about 3 cm anterior to the occiput. Not more than a finger can be inserted between the heel of the blade and the head.

the vaginal wall to reach the flexion point that is 3 cm in front of the occiput on the sagittal suture.

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Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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