Skill LabDone by:
Nuney
Placenta Increta
• Placenta Increta invasion
Invasion of myometrium
Uterine wall
Placenta previa centralis covering the internal os
Cervix
• The other half of the previous uterus.
A vessel ( just an opening )
• Another view from another side.
Ovary
فلين
Placenta Increta
• Another placenta with part of the uterus..
Umbilical cord
Placenta
Part of the uterus
Fibroid
Multiple Fibroids
Tubal Ectopic Pregnancy
Vesicular Moles
Teratoma
The Uterus
• Hysterectomy
Intrauterine device
Short (wriglx) Forceps*
• Traction of the head of the baby in obstructed labor.
• To differentiate between right & left:
الكونكافيتي باليمين تمسكي لمنجوه ومن فوق على ..تكون
اسمه قال اكمل wriglx ****الدكتورor
low forceps تقولي يكفي
vorcellum Forceps*
• Used to grasp the cervix during gynecological procedure (can’t be used in pregnant ladies) so used in non pregnant cervix
Doyen retractor*
• Traction of the bladder & the inferior peritoneal …. To expose the lower uterine segment in C/S.
Bivalve (Cusco’s) Speculum*
• Vaginal speculum• Used for exposure and
to visualize the cervix and vagina in cases of
1 .Inspection of cervix & vagina (pap smear, discharge, swab)
2 .High vaginal swab3 .Confirm PROM
4 .IUD insertion
endometrial curette*
• Used for currtage of endometrium in D&C
• ذهبي واحد اتنين فيهوالتاني مصدي شكلهيعني خخخخ فضي
التلخبطوا عشان
Hegar dilator*
• Used for dilatation of endometrium in D&C
• احجام منه موجودمختلفة
Needle Holder*
• To hold the needle of the suture.
Sim’s Speculum*
• Vaginal speculum• Used to visualize the
cervix and vagina for1. Inspect vaginal wall
for lesions (fistula, prolapse, neoplasm)
2. D&C3. Exploration in PPH
Curved & straight artery forceps*
• To ligate the arteries.
• Used to hold peritoneum and to ligate uterine artery.
وبين • بينه الفرقموجود انه السيزورالسنون زي فيه
حادة الصغيرة
Kidney shape plate*
Metal catheter*
مهم • مو قال اكمل الدكتور
E.M.Al-Awami
Forceps Indications:
1.Fetal: distress, cord prolapse
2.Maternal:
*shorten the 2nd stage (cardiac disease, pul.edema, hypertension, neurological dysfunctions)
*Maternal exhaustion
*Poor maternal effort
3.Elective:
*After coming head in breech.del.
*During caesarean section
bladelock
shank
handle
E.M.Al-Awami
ForcepsPre-requisites:
Fetal:
1. Head engaged ( station +2 or lower)
2. Vertex or face presentation
3. Position of the fetus precisely known
Maternal:1. Cervix fully dilated
2. Membrane must be ruptured
3. No cephalopelvic disproportion
4. Bladder empty
5. Adequate analgesia & anesthesia
6. Generous episiotomy
7. Lithotomic position
8. Empty rectum Contraindications are the opposite to them!
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Forceps
Complications:Fetal:1. Facial n.or brachial
plexus injury
2. Skull fractures
3. Heamatoma (caput saccundum)
4. Intracranial Hge
Maternal:
1. Tear and laceration of the cervix
2. Rupture of bladder
3. Extension of episiotomy
4. Bleeding
5. Infections
E.M.Al-Awami
Types of forceps
a. Simpson b. piper
English lock
Traction forceps Delivery of after coming head in
breech
Long shank
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Sliding lock
c. Kielland
Rotational forceps
Types of forceps
E.M.Al-Awami
Vacuum extractor cup *
Indications, Prerequisites & Contraindications
Same as forceps.. PLUS few more points !
Prerequisites:• Full term baby• Full flexion of the head• Suction pressure < 600
mmHg• Not more than 3
application • Don’t twist the cup !
كمان suction apparatusفيه
الصورة في بسمشموجود
تقولي ventoseيكفي
Contraindications:
1. Face or other than vertex presentation
2. Premature baby
3. Fetal coagulopathies
4. Fallowing fetal scalp sampling!
Vacuum extractor cup
Complication:
1. Vaginal laceration and fistula
2. Fetal scalp heamatoma, laceration
E.M.Al-Awami
Pap’s smear set
Uses:
Obtain cytology smear form the cervix and vagina ( screening purposes)
E.M.Al-Awami
Ayre’s spatula (2 ends)
Endocervical swab fixator slide
Components
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Swap for culture
Use:
1.Obtain swab form any fluid or discharge
2.High vaginal swab
E.M.Al-Awami
Nitrzine test
• Looks like a swab but has a yellow head ..
• Used to confirm rupture of membrane
Alkaline amniotic fluid
Yellow Blue
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Fetal scalp electrode(internal monitor)
Uses:Record fetal ECG by applying
small clip to fetal scalp.
Indications:1. Chorioaminoitis
2. Meuconium stained liquor
3. Twins
4. Excessive fetal movement
5. Unsatisfactory CTG
6. High risk pregnancy
E.M.Al-Awami
Fetal scalp electrode
Advantages:
More reliable tracing to fetal heart beat & variability..
Disadvantages:
1. Rupture of membrane is a must; spontaneous or artificial
2. Little chance of infection; mother & fetus
3. Scalp trauma
Contraindications:
1. Maternal infection e.g HIV, herpes simplex
2. Sever fetal coagulopathy
E.M.Al-Awami
Sponge forceps(ovum forceps* without lock)
Curved
* Straight
Uses:
1. Remove conceptional product, intrauterine, cervical polyp
2. To hold tissue e.g cervix during D&C
Ring Forceps (with lock)
الب السكل في موجود اللي هوا
Ovum forceps (without lock) مشموجود
Used to grasp the cervix during gynecological procedure (can be used
in pregnant).
Amni-hook perforator
Use: non pharmacological induction of labor
(Rupture membrane)
Complication:1. Fetal & maternal injuries
2. Cord prolapse
3. Rupture of vasa previa
4. Chorioaminoitis
Sharp end
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Amni-hook perforator
Advantages:
1. Accelerate labor
2. Help see liquor
Contraindications:
1. Intrauterine fetal death
2. Maternal infections e.g HIV, herpes simplex
E.M.Al-Awami
كم عليها زودت انا العام بنات حقت هادي المحاضرهاكمل الدكتور شرحها اللي من ساليدة
* ملون والكالم عالمة فيها حتالقوا شرحها واللياالورنجي باللون
تعرفوا شي name and use of each واهمinstrument
ماقاله الباقي بسوسالمتكم
BEST WISHESDr.Mano