Operative Vaginal Deliveries
Release Date:
Incidence:
3.3% as of 2013
Indications:
Prolonged second stage
Risk of fetal compromise
Shortening 2nd stage for maternal benefit (ex: cardiac conditions)
Consent:
Comparison is c-section typically
Failure rate of OVD is ~3-6%
Forceps has higher success rate over vacuum, but also higher risk 3rd/4th degree tear
Risks to both mom and baby
Prep:
Fetus appropriate station/position
Anesthesia
Empty bladder
Assess Pelvis/Passenger sizes/fit
OR Ready
Peds available
Episiotomy – NO!
Contraindications
Fetal conditions, known or supspected: bone disorders (OI), bleeding disorders
Maternal infections: Hep C, HIV, etc
Concern for shoulder dystocia/cephalo-pelvic dysproportion
Operative Vaginal Deliveries