Obstetric procedures

2020 ◽  
pp. 407-421
Author(s):  
Yvonne Kwan Yue Cheng ◽  
Tak Yeung Leung
Keyword(s):  
Caesarean Section ◽  
Surgical Procedures ◽  
Natural Process ◽  
External Cephalic Version ◽  
Perineal Tear ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
The Third ◽  
Third Stage ◽  
Controlled Cord Traction

Human childbirth is a natural process but it is not always smooth and successful. Hence, several important obstetric surgical procedures and instruments were invented to assist difficult childbirth, such as caesarean section, forceps and vacuum vaginal delivery, external cephalic version, and vaginal breech delivery. The indications, the procedures, and the complications of these commonly practised obstetric surgeries are reviewed in this chapter. Other commonly performed procedures for normal labour such as episiotomy, repair of perineal tear, routine controlled cord traction for the delivery of the placenta in the third stage of labour, and manual removal of retained placenta will also be discussed.

External Cephalic Version at Term with Tocolysis

1988 ◽  
Vol 18 (3) ◽  
pp. 119-124 ◽  
Author(s):  
G Justus Hofmeyr
Keyword(s):  
Developing Countries ◽  
Caesarean Section ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Cephalopelvic Disproportion ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
High Prevalence ◽  
Large Families ◽  
Tocolytic Agents

The problems associated with breech presentation are of particular importance in developing countries. The risk of vaginal breech delivery may be increased because of a high prevalence of cephalopelvic disproportion. Caesarean section presents specific risks to women who may not have medical care in subsequent pregnancies and may desire large families. External cephalic version (ECV) before term has not been proved conclusively to influence the outcome of pregnancy. ECV performed at term (37 or more weeks gestation), using tocolytic agents to relax the uterus, has been shown in a technologically developed setting to reduce the incidence of breech presentation and of Caesarean section. The application of this procedure when technological facilities are limited is discussed and the technique is described.

Variations in the Management of Singleton Breech Presentation Throughout Scotland

1998 ◽  
Vol 43 (5) ◽  
pp. 144-145 ◽  
Author(s):  
S. Z. S. Yahya ◽  
J. Williams ◽  
A. Mathers ◽  
S. Bjornsson ◽  
A. D. Cameron ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Breech Presentation ◽  
Postal Questionnaire ◽  
External Cephalic Version ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Post Procedure ◽  
Line Management

Breech presentation occurs in 3–5% of deliveries and can be managed by either a trial of vaginal breech delivery (TOVBD), external cephalic version (ECV) or Caesarean section.1 A postal questionnaire was completed by 82% of Scottish consultant obstetricians and revealed wide variations in practice. Eighteen percent never offered ECV. Among those who did consensus was lacking on some contraindications. One-quarter sometimes performed ECV before 37 weeks gestation despite the possibility ofspontaneous version. Only 70% restricted ECV to one or more designated operators thereby maintaining levels of expertise. Variations were demonstrated in the use of tocolytics, and pre and post procedure investigations. Following failed ECV 28% considered a repeat attempt and 56% a TOVBD. TOVBD was not offered asjirst line management by one-fifth of respondents. Those who did varied in the pre-procedure investigations performed. Guidelines are required to ensure safe, consistent practice and avoid unnecessary Caesarean sections.

Controlled cord traction for the third stage of labour

2009 ◽  
Author(s):  
Nolundi T Mshweshwe ◽  
G Justus Hofmeyr ◽  
A Metin Gülmezoglu
Keyword(s):  
The Third ◽  
Third Stage ◽  
Controlled Cord Traction

scholarly journals Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

The Lancet ◽  
2012 ◽  
Vol 379 (9827) ◽  
pp. 1721-1727 ◽  
Author(s):  
A Metin Gülmezoglu ◽  
Pisake Lumbiganon ◽  
Sihem Landoulsi ◽  
Mariana Widmer ◽  
Hany Abdel-Aleem ◽  
...  
Keyword(s):  
Active Management ◽  
The Third ◽  
Third Stage ◽  
Controlled Cord Traction ◽  
Randomised Controlled

scholarly journals Controlled cord traction for the third stage of labour

2015 ◽  
Author(s):  
G Justus Hofmeyr ◽  
Nolundi T Mshweshwe ◽  
Ahmet Metin Gülmezoglu
Keyword(s):  
The Third ◽  
Third Stage ◽  
Controlled Cord Traction

Prematurity, multiple gestation, and abnormal presentation

2016 ◽  
Author(s):  
Oonagh Keag ◽  
E. Sarah Cooper
Keyword(s):  
Preterm Labour ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
External Cephalic Version ◽  
Multiple Gestation ◽  
Antenatal Corticosteroids ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Maternal Risks

Preterm labour is a common cause of neonatal morbidity and mortality. This chapter describes the definition, aetiology, diagnosis, and management of preterm labour and delivery with a focus on tocolytic therapy, the use of antenatal corticosteroids, and of magnesium sulphate. Anaesthesia for preterm delivery is discussed. The section on multiple pregnancy details the recommended antenatal careplan for dichorionic and monochorionic twin pregnancies, the fetal and maternal risks and potential complications, and the management of labour and delivery of twins, as well as the anaesthetist’s role in managing these high-risk pregnancies. There are a number of abnormal presentations managed by obstetricians, including abnormal cephalic presentations such as occiputo-posterior positions, breech, transverse, and compound presentations. This chapter focuses specifically on breech presentation, comparing the evidence for vaginal breech delivery versus planned caesarean delivery. It also discusses external cephalic version and vaginal breech delivery itself.

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