Vaginal Speculums
Sim’s
speculum
This is for vagina only
Best for vaginal wall
Cusco Speculum. To look
at the cervix.
Identify the instrument / treatment?
Vaginal Speculums
The uses / indications of the instrument
It is Used during clinical examination to visualized the vagina
and the cervix
if they ask you specify you should say: cervix
Contraindications of the instrument use
History of vaginal bleeding
Prerequisites for the use of instrumen
Sterilize it if it is metallic but nowadays some of the hospitals
use a plastic disposal one.
Complications of the use of the instrument
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Points about the disease in relation to the instrument
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To visualize the
cervix.
Cusco Speculum
Grave Speculum
Devilbiss Speculum
Choose according to the shape of the vagina
Surgical Retractors
What is the name?
Surgical Retractors
What are the uses ( indications- diseases ) ?
Used during abdominal or pelvic surgeries
(the big one is the main instrument that is usually used to hold the
lower segment of the uterus in C. section to get the baby out.)
Any contraindications?
-
Any Prerequisites ( conditions) ?
-
Any Complications can happen during or after ?
Amniohook
Put it opposite
to your finger
What is the name?
amniohook
What are the uses ( indications- diseases ) ?
To rupture the membrane (amniotomy)
Any contraindications?
- IF there is infections like ( herpes , hepatitis )
- Rule out placenta previa
Any Prerequisites (conditions) ?
Dilated cervix: if >2 cm or if you can put 2 fingers in.
Engagement of the head - to avoid cord prolapse which may
lead to asphyxia and death
Check if the mother has infections
Check if the placenta is in the right place
Any Complications can happen during or after?
Vaginal or cervical injury
Doyen’s Retractor
What is the name?
Doyen’s retractor
What are the uses ( indications- diseases ) ?
To retract the lower utrine segment or the abdominal tissue
during surgery. (to retract the urinary bladder in particular)
Any contraindications?
-
Any Prerequisites ( conditions) ?
-
Any Complications can happen during or after?
May cause contusions of the bladder resulting in hematuria
Forceps
Kiellands forceps
The only one that has
sliding hook wrigleys:
Here it can be used to Can be used
rotate the head if it is when the head is
occepto-posterior as below zero
well as pulling the fetus. station we use
Unlike the other types (out-let forceps)
that only pull but don’t
rotate.
(it can be used when the
head is very high –
midcavity forceps) Simpsons: we use it when the head as high as -1
station. It is also used in C.S. if the fetus is breech
What is the name?
FORCEPS
What are the uses ( indications- diseases ) ?
Pull the head of the fetus if it is low down in the vagina +1 or below 0
Any contraindications?
1. Cephalo pelvic disproportion (CPD)
2. Malpresentation “face”
3. Very immature fetus
4. Big Baby
Any Prerequisites ( conditions) ?
[Link] dialated cervix
2. engamgment of the head
[Link] fetus must be occepto-anterior
[Link] bladder and rectum
Important
[Link]
6. The Examiner must have experience
7 . ruptured membrane
[Link] presentation
[Link] pelvic for the fetus to come out.
[Link] anesthesia
Any Complications can happen during or after ?
1. May tear the vaginal wall and cause bleeding.
2. for Kiellands forceps, when it is rotated it may damage the infant.
That’s you only selected people are using it.
Vacuum OR Ventose
What is the name?
Vacuum or ventose
What are the uses ( indications- diseases ) ?
Same as in forceps except the direction of the baby ... here even if the fetus head is
not occepto-anterior we still can use it. You also can do rotation and pulling in the
same time
Any contraindications?
1. Cephalo pelvic disproportion (CPD)
2. Malpresentation “face”
3. Very immature fetus
4. Big Baby
Any Prerequisites (conditions)?
[Link]’t place it at the site of anterior frontalis you could injured the brain.
[Link] your finger and take a round around the vacuum to make sure the vagina is
not included
[Link] you vacuum start one .. two .. and by the third time the fetus should be
out. If the third attempt fails to pull the baby, the ventose should be discontinued.
Any Complications can happen during or after ?
- Edema - laceration of fetal head
- Maternal tissue (vaginal) injury if you pull it by mistake
Hegar’s Dilators
What is the name?
Hegar’s Dilators
What are the uses ( indications- diseases ) ?
[Link] the cervix in gyne operations (dilatation and curettage)
2. when inserting IUCD
Any contraindications?
(never used in laber)
Any Prerequisites ( conditions) ?
…
Any Complications can happen during or after ?
[Link] laceration
[Link] of the uterus
Uterine Sound
What is the name?
Uterine sound
What are the uses ( indications- diseases ) ?
To measure the uterine cavity length before certain procedures like
dilatation and curettage. Also, to assess the position of the uterus.
Any contraindications?
..
Any Prerequisites ( conditions) ?
…
Any Complications can happen during or after ?
Perforation.
Curette
What is the name?
Curette. Type:
[Link]: never use in pregnancy
[Link]: used for abortion if there was retained tissues
What are the uses ( indications- diseases ) ?
Diagnostic curettage: bleeding .. amenorrhea .. sterility
Therapeutic curettage: for temporary or permanent cure of non-
malignant uterine bleeding
Any contraindications?
Any Prerequisites ( conditions) ?
Don’t go vigorously into the basalis layer of the endometrium to avoid
adhesions (asherman syndrome).
Any Complications can happen during or after?
- Perforation
- Asherman syndrome ( if you remove the basalis of endometriam)
Fetal Scalp Electrode
What are the uses ( indications- diseases ) ?
It is connected to the CTG to record the fetal heart rate during labor. It is used
when the transabdominal CTG fails to record good fetal heart measures or in
case of twins (the first one is monitored by the electrode while the other by
the transabdominal method)
Any contraindications?
Any Prerequisites ( conditions) ?
Any Complications can happen during or after?
[Link] to the maternal tissue.
2. spread of infections from the mother to baby (hepatitis – HIV)
Green Armitage Clamp
What are the uses (indications-
diseases) ?
It is usually used during the operation
on the lower uterine segment like C
section, to hold the flaps of the
uterine incision to control bleeding
Any contraindications?
Any Prerequisites ( conditions) ?
Any Complications can happen
during or after ?
Cervical Clamps Tenaculum / Vulsellum
1 tooth
2 or more teeth
What is the name? Cervical clamps
What are the uses ( indications- diseases ) ?
To catch the cervix in vaginal surgery (also in hysterectomy)
Any contraindications?
You can use it in pregnancy but be gentle.
Any Prerequisites ( conditions) ?
Any Complications can happen during or after ?
May cause bleeding
Ring (Sponge) forceps
What is the name? Ring sponge Forceps
What are the uses (indications)?
In pregnancy, this is preferable to hold the
cervix (not traumatic)
1. to gasp the soft lips of the cervix and
evacuate a pregnant uterus per vagina.
2. Used to remove corporeal and cervical
polyps
3. Can be used as a sponge carrier
Any contraindications?
Any Prerequisites ( conditions) ?
Any Complications can happen during
or after ?
Urethral Catheters
What is the name?
Urethral Catheters
1- Rubber 2- metalic
What are the uses ( indications- diseases ) ?
To evacuate the bladder
The rubber type can be used to induce labor
Any contraindications?
Any Prerequisites (conditions)? Sterilization.
Any Complications can happen during or after ?
1- Infection 2- urethral injury (truma)
Laparoscopic Set
Laparoscope
Trocar (Sleeve & Needle) Veress Needle
What is the name?
Laproscope. ( if they ask you about the name in the exam say laparoscope )
What are the uses (indications-diseases)?
Laparoscopy is a surgical procedure in which a fiber-optic instrument is inserted
through the abdominal wall to view the organs in the abdomen or permit small-
scale surgery.
(it gives you magnification of the organs )
Veress needle indications:
1- To make incision in the laparoscopic procedure.
2- For CO2 inflation of the abdomen prior to laparoscopy. (to create
pneumoperitonium)
Laproscope indications : (used for laparoscopy)
1- Therapeutic: ectopic pregnancy – tubal ligation – adhenolysis.
2- Diagnostic: PID – infertility – endometriosis.
Any contraindications?
Any Prerequisites ( conditions) ?
Any Complications can happen during or after ?
1- Infections 2- bleeding (laceration of vessels ) 3- bowel perforation
4- subcutaneous emphysema 5- adhesions are more in laprotomy
Cervicala Spatula & Cytobrush
What is the name?
Cervicala Spatula & Cytobrush
What are the uses ( indications- diseases )
Used for pap smear.
1. HPV
2. cervical cancer
3. Routine exams
4. Post coital bleeding
Any contraindications? Detailed in
Any Prerequisites ( conditions) ? Contraception
Any Complications can happen during or after ? lecture
Intrauterine Contraceptive Device (IUCD)
What is the name?
Intrauterine Contraceptive Device (IUCD)
What are the uses ( indications- diseases ) ?
Contraception. (0.3% failure)
Any contraindications?
1- Pregnancy – ectopic pregnancy
2- IPD
3- Perforation because of an IUCD
4- History of ectopic pregnancy (better not to)
Any Prerequisites ( conditions) ?
Any Complications can happen during or after ?
1- Perforation 2- infections
2- Irregular vaginal bleeding
3- The copper one will cause heavy bleeding
Detailed in fetal
assessment
Amniocentesis lecture
What are the uses ( indications-
diseases ) ?
1- Cytogenetic 2- keryotyping
Any contraindications?
Any Prerequisites ( conditions) ?
Any Complications can happen
during or after ?
Ring Pessary
What is the name?
Ring passary
What are the uses ( indications- diseases ) ?
Pelvic prolapse (for those who can’t go for surgery like old women)
Any contraindications?
Any Prerequisites ( conditions) ?
Any Complications can happen during or after ?
1- Infections With improper prolonged
2- Lacerations use
Birth Control Pills (OCP)
Detailed in
Contraception
lecture
What is the name?
Birth control pills (OCP)
What are the uses ( indications- diseases )
Each type has indications.
Any contraindications?
1- Personal hx of thrombosis+ known clotting disorders
2- Personal hx of strok and mi
3- Labile HTN
4- Active liver disease
5- Estrogen sensitive malignancy ( such as breast cancer)
6- Migraines with focal neurologic symptoms
7- DVT – warfarin
Any Prerequisites (conditions) ?
Any Complications can happen during or after ?
Side effects : breast tenderness – decrease ibido – headache – weight gain
Question: What is this and what is it used for?
Vaginal Speculums.
Used during clinical
examination to visualized the
vagina and the cervix.