Gynae and Obs Instruments:
Complications (All):
Trauma, Hemorrhage, Perforation, Infection.
Tooth forceps
1. Plain forceps
It is used to hold delicate structures like vessels, peritoneum
and bowel wall.
It aids in holding and diathermizing bleeder.
Plain forceps
Tooth forceps:
It is used to hold skin, subcutaneous tissues and needle.
2. Straight artery forceps
It is used to hold the cut edges of fascia, peritoneum and
aponeurosis.
3. Curved artery forceps
It is used to hold the cut edges of fascia and
aponeurosis.
It is used as a hemostat.
Long artery forceps: Used as a hemostat for grasping, clamping and ligating vessels.
4. Needle holding forceps
It is used to stabilize the needle.
5. Straight scissors
It is used for suture cutting.
6. Curved scissors
It is used for tissue cutting.
7. Sim’s speculum
It is used to retract the posterior vaginal wall. It is not self
retaining.
Patient position: Sim’s position, lithotomy position, semi-
lateral position
Uses: D&C, D&E, vaginal hysterectomy, biopsy, per speculum
examination
8. Cusco’s speculum
It is used to retract the posterior vaginal wall. It is self
retaining.
Patient position: any position or dorsal position.
Uses: Pap smear, per speculum examination, insertion of
IUCD.
9. Doyen's retractor
It is used to retract the anterior abdominal wall and
bladder during C-Section and hysterectomy.
10. Deaver's retractor
It is used to retract intra abdominal viscera like liver.
It is used to retract bladder and uterus during
Abdominal Perineal Resection.
11. Metallic urinary catheter
It is used to empty the bladder prior to major vaginal
operations.
It is used to confirm diagnosis of Gartner’s cyst from
cystocele.
12. Uterine sound
It is used to measure the size and direction of the uterus.
It is used to measure the length of the cervix.
It is used to detect any pathology like fibroid, tumor, polyp
and anomalies of uterus.
It is used for D&C.
13. Hegar's cervical dilator
It is used to dilate the cervix.
Uses: D&C, D&E, amputation of cervix, to diagnose
incompetent os of cervix.
14. Sponge forceps
It is used for holding sponge to clean operative field.
It is used to hold retained products of conception.
It is used for packing.
15. Uterine curette
It is used to scrape endometrium from uterine cavity.
Uses: Missed abortion, incomplete abortion, patients with
~
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--/B PMB, suspected endometrial carcinoma.
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16. Anterior vaginal wall retractor
It is used with Sim’s speculum to visualize cervix and
vagina.
· It is useful in case of cystocele.
17. Towel clip
It is used to hold towels and drappers.
18. Small bowl
It is used for Pyodene or spirit.
19. Kidney tray 500 ml
It is used to hold surgical specimens.
It is used to handle sharp instruments.
It is used to collect blood and empty the bladder.
20. Allis forceps
It is used to hold tough tissues such as rectus sheath
during procedures like abdominal hysterectomy,
tubectomy and LSCS.
21. Green armytage forceps
It is used as a hemostat in C-Section.
It is used to hold the edge of the uterus.
22. Vulsellum forceps
It is used to hold and grasp the cervix.
Uses: D&C, cervical biopsy and cautery, vaginal
hysterectomy, Manchester repair.
Maternal Complications: Fetal Complications:
Genital tract trauma Chignon, cephalohematoma, subgleal hematoma,
Hemorrhage intracranial hemorrhage, retinal hemorrhage
23. Suction cannula
One end is inserted into the uterine cavity to suck out its
contents while the other end is connected to the suction
apparatus.
Uses: D&C, incomplete abortion, missed abortion,
endometrial biopsy.
24. Vacuum extractor (Ventouse delivery)
Circumference diameter should be 30, 40 or 50mm
Vacuum pressure: 0.8kg/cm
2
Jaw delivered then vacuum should be detached
Whole vacuum should be completed in 15 mins
If the vacuum is detached after the second time, don’t
attach it again or any other instrument. Go for C-Section.
Prerequisites: Gestational age > 34 weeks
Position: lithotomy
Site of application: 6cm away from anterior fontanelle
and 3cm away from posterior fontanelle (at vertex).
Indications:
Contraindications:
Delay in 2nd stage of labour
Face presentation, Breech presentation,
Maternal conditions requiring a
Gestational age <34 weeks, Head not fully
short 2nd stage: cardiac disorders,
engaged, Cervix not fully dilated, Bleeding
respiratory disorders
from fetal blood sampling site.
Used when the baby’s head is at +3 station. Always hold in left hand and apply gentle
pressure on the shank with the right hand.
25. Outlet forceps/Wrigley’s forceps (Low cavity forceps)
Handle Prerequisites:
Head engaged (less than 2/5th palpable).
Shank
No malpresentation.
Cephalic curve
Lock
(inside) Bladder should be empty.
Cervix should be fully dilated.
Pelvic curve
(Outside) Fetal Complications: Maternal Complications:
Facial nerve palsy Lacerations to genital tract and
Skull fracture uterus
Intracranial hemorrhage Anal sphincter trauma
Orbital injury
Indications:
Prolonged 2nd stage of labour
Ventouse is safer for
Face presentation
mother but Forceps is
Delivery before 34 weeks
safer for baby.
Bleeding from fetal blood sampling site
Contraindications:
Cervix not fully dilated
Head not engaged
Malpresentation
Inexperienced clinician
Inadequate pelvic dimensions
