Obstetric Instruments — OSCE Quick Revision Guide
How to use this in the exam: for each instrument (1) sketch the outline + label the parts listed, (2) identify it in 2–3 lines, (3)
list uses as numbered points. Speed of identification + structured uses is what's rewarded, not artistic drawing.
1. Catheters
Simple Rubber Catheter
Parts to label: single lumen tube, rounded tip with side hole (eye), plain open end
Uses:
1. Retention of urine in: pregnancy (retroverted gravid uterus), labor (before/after operative delivery, or if woman can't
void), postpartum (PPH management, retained placenta)
2. Other uses: as a tourniquet, to give O2 if no nasal catheter, as a mucus sucker (attached to suction machine)
Foley's Catheter
Parts to label: balloon (inflatable cuff near tip), inflation port/valve, drainage lumen, connecting end for bag
Uses:
3. Continuous bladder drainage in eclampsia, retroverted gravid uterus
4. Rest to bladder after destructive operation / suspected bladder injury (kept 7–10 days)
5. Balloon tamponade for atonic PPH — inserted into uterine cavity, balloon inflated with saline to tamponade the uterine
surface, drains residual blood
High-yield: examiners love asking about Foley's use in PPH tamponade — mention this first.
2. Vaginal Specula
Sims' Double-Bladed Posterior Vaginal Speculum
Parts to label: two blades of unequal breadth (narrow = nulliparous, wide = parous), duck-bill/boot shape, handle
Uses:
6. Inspect cervix/vagina for injury after delivery
7. Clean vagina after delivery
8. Exclude local cause of bleeding in APH (Cusco's preferred though)
9. During D&E operation
Cusco's Bivalve Self-Retaining Speculum
Parts to label: two blades (bivalve), screw/ratchet lock (self-retaining), handle
Uses:
[Link] cervix & fornices — local cause of APH (polyp, ectopy)
[Link] smear for cytology
[Link] liquor leakage from os in suspected PROM
3. Holding / Grasping Forceps
Multiple-Toothed Vulsellum
Parts to label: multiple interlocking teeth at tip, ratchet handle
Uses:
[Link] anterior lip of cervix in D&E / suction evacuation
Causes trauma to soft vascular cervix → Allis forceps preferred now.
Allis Tissue Forceps
Parts to label: fine teeth at tip (less traumatic than vulsellum), ratchet
Uses:
[Link] anterior lip of cervix (D&E)
[Link] apex of episiotomy wound during repair
[Link] peritoneum / rectus sheath / vaginal mucosa margins during repair
[Link] torn ends of external anal sphincter (complete perineal tear repair)
[Link] uterine flap margins/angles in LSCS (alternative to Green-Armytage)
Giant Vulsellum
Parts to label: large, wide-mouthed teeth, long handle
Uses:
[Link] in destructive operations (e.g. evisceration) to grip fetal parts for traction
Sponge Holding Forceps
Parts to label: oval fenestrated jaws, ratchet lock
Uses:
[Link] vulva/vagina/perineum before & after delivery
[Link] painting of abdomen before LSCS
[Link] hold membranes if tearing during placental delivery
[Link] cervix (2 pairs) to inspect for cervical tear
[Link] cervix during cervical encirclage (cerclage)
4. Hemostatic / Clamping Forceps
Long Straight Hemostatic Forceps
Parts to label: straight jaws, ratchet
Uses:
[Link] commonly used in obstetrics
[Link] pedicle while removing uterus in rupture uterus
[Link] for clamping the umbilical cord
Kocher's Hemostatic Forceps
Parts to label: transverse serrations + 1x1 teeth at tip (toothed tip is the key identifying feature)
Uses:
[Link] umbilical cord (better grip / crushing effect to occlude vessels)
[Link] rupture of membranes for surgical induction / augmentation of labor
Green–Armytage Hemostatic Forceps
Parts to label: curved jaws matching lower uterine segment incision curve, atraumatic serrations
Uses:
[Link] in LSCS — 4 forceps needed (one per angle, one per flap)
[Link] hemostasis and holds margins for suturing
Cannot be used in classical CS. Alternative: Allis forceps.
5. Scissors
Long Straight Scissors
Parts to label: straight blades, ring handles
Uses:
[Link] umbilical cord
[Link] episiotomy
[Link] suture material (e.g. in cesarean section)
Episiotomy Scissors
Parts to label: angled/bent-on-edge blades, one blunt-tipped blade (goes inside vagina)
Uses:
[Link] episiotomy — blunt tip prevents injuring fetal head/maternal tissue
6. Uterine / Cervical Instruments
Uterine Sound
Parts to label: olive-tipped end, graduated markings, malleable metal shaft, handle
Uses:
[Link] uterine position & cavity length before cervical dilatation (D&E)
[Link] foreign body (e.g. IUCD) in cavity
[Link] as first (smallest) cervical dilator
Cervical Dilators (Hawkin-Ambler / Hegar's)
Parts to label: double-ended, graduated tapering rods, size numbers marked. Hawkin-Ambler: 16 sizes, 3/6 to 18/21.
Hegar's/Das: double-ended, 1/2 to 11/12 (number = diameter in mm)
Uses:
[Link] cervical canal before evacuation
[Link] abortion → dilate enough for index finger (~16/19)
[Link] evacuation → one size smaller than the suction cannula
[Link] by D&E → enough for ovum forceps (~9/12)
Flushing Curette
Parts to label: blunt loop/cup end, hollow shaft (communicating channel)
Uses:
[Link] curettage in D&E
[Link] used to flush the uterine cavity with antiseptic solution
Uterine Curette
Parts to label: sharp loop at one or both ends, long handle
Uses:
45.D&C for incomplete abortion
[Link] curette used in D&E (soft uterine wall)
47.D&C one week after hydatidiform mole evacuation
Uterine Dressing Forceps
Parts to label: long, curved, transversely serrated blades (vs. grooved blades in laminaria forceps — key difference)
Uses:
[Link] uterine cavity after D&E (with gauze pieces)
[Link] cervix in lochiometra/pyometra
Laminaria Tent Introducing Forceps (+ Laminaria Tent)
Parts to label: grooved blades (to hold the tent), the tent itself (thin rod)
Uses:
[Link] cervical dilatation — laminaria (dehydrated seaweed) swells via hygroscopic action after insertion
[Link] in alcohol for 24 hrs; multiple tents used to avoid gap between ends
[Link]/Isogel tents = alternative, made from mucilaginous seed husks
7. Evacuation / Suction Instruments
Manual Vacuum Aspiration (MVA) Syringe
Parts to label: plunger with locking pins, cylinder (barrel), valve/cannula connector
Uses:
[Link] evacuation up to 12 weeks
[Link]: simple, safe, outpatient, local anesthesia, 98% effective, less traumatic, quick (10–15 min)
Plastic Suction Cannula (Karman's type)
Parts to label: hollow tube, side hole near tip, color-coded connector hub (size-coded)
Uses:
[Link] to MVA syringe for suction evacuation (S+E)
[Link] 4–12 mm roughly match gestational weeks: 4–6 wks → 4–7mm; 7–9 wks → 5–10mm; 9–12 wks → 8–12mm
[Link] over metal cannula: less uterine damage, contents visible
[Link] must be broken before withdrawing
Ovum Forceps
Parts to label: long shaft, fenestrated slightly bent blades, NO ratchet/catch (key feature)
Uses:
[Link] products of conception in D&E/MTP
[Link] catch minimizes uterine injury if accidentally caught
[Link] closed, opened inside cavity, withdrawn with slight rotation (aids detachment, reduces trauma)
8. Retractors
Doyen's Retractor
Parts to label: curved, broad blade with handle (boot/hook shape)
Uses:
[Link] abdominal wall + bladder during LSCS for lower segment exposure
[Link]: insert after opening abdomen → remove temporarily during baby delivery → reinsert → remove after
peritoneal toileting
9. Obstetric (Delivery) Forceps
Long Curved Obstetric Forceps (classic anatomy — draw this one fully)
Parts to label: blade (cephalic curve + pelvic curve), shank, lock/screw, finger guard, handle
Uses:
[Link] used for low forceps operation
Short Curved Obstetric Forceps (Wrigley's Forceps)
Parts to label: shorter shank, prominent cephalic curve, minimal/no pelvic curve
Uses:
[Link] forceps only — extraction of head when already on the perineum (e.g. at LSCS, or quick outlet delivery)
Kielland's Forceps
Parts to label: minimal pelvic curve (almost straight), sliding lock (asymmetric lock — allows correction of asynclitism)
Uses:
[Link] forceps — deep transverse arrest, occipito-posterior position, unrotated vertex or face presentation
Forceps' Axis Traction Device
Parts to label: axis traction rods (right & left), traction handle
Uses:
[Link] onto blades of long curved forceps before application; used when strong traction is needed (mid-forceps) —
now rarely used
10. Vacuum Extraction
Ventouse Cup with Traction Device
Parts to label: metal/silicone cup, suction hole, traction chain/rod, handle
Uses:
[Link] extraction of fetal head — cup applied to scalp, vacuum creates a 'chignon' (artificial caput) for grip; cups come
in various sizes
11. Destructive Operation Instruments
Perforator (Oldham's)
Parts to label: sharp pointed, scissor-like cutting blades, strong handle with ratchet
Uses:
[Link] — perforates fetal skull for decompression (obstructed labor with dead fetus, hydrocephalus, etc.)
Giant Vulsellum — see Section 3; used with the perforator in destructive operations for traction on fetal parts.
12. Neonatal Resuscitation Instruments
Mucus Sucker (Disposable / Metal)
Parts to label: Disposable: tubing at both ends + collection chamber. Metal: central bulb/chamber, one end for rubber catheter
(to baby), other end for gauze-covered mouth end
Uses:
[Link] mucus from naso-oropharynx immediately after head delivery, before the baby's first breath — prevents
aspiration/asphyxia neonatorum. Now mostly replaced by electric/disposable suction.
Cord Clamp (Disposable, Plastic)
Parts to label: serrated locking jaws, single-direction ratchet lock
Uses:
[Link] umbilical vessels; left in place until it auto-detaches with the cord stump
13. Auscultation
Pinard's Fetal Stethoscope
Parts to label: trumpet/cone shape, wide bell end (against abdomen), narrow aural end (against examiner's ear)
Uses:
[Link] fetal heart sounds. Hold firmly at right angles to the abdominal wall; don't touch with hand while listening
(loses contact/transmits extra sound)
Quick Mnemonics / Traps Examiners Like
Confusable pair How to tell apart
Uterine dressing forceps vs. Laminaria tent forceps Serrated blades = dressing forceps; grooved blades = laminaria
forceps
Simple rubber catheter vs. Foley's Foley's has a balloon near the tip
Sims' vs. Cusco's speculum Sims' = two separate blades (bivalve open); Cusco's =
hinged/self-retaining with screw lock
Vulsellum vs. Allis forceps Vulsellum = coarse interlocking teeth (traumatic); Allis = finer
teeth (less traumatic)
Long curved vs. Wrigley's vs. Kielland's forceps Long curved = full pelvic + cephalic curve (low forceps);
Wrigley's = short, outlet only; Kielland's = minimal pelvic curve,
sliding lock (rotational)
Ovum forceps vs. sponge holding forceps Ovum forceps has no ratchet/catch; sponge holder has a ratchet
Kocher's vs. long straight hemostatic forceps Kocher's has 1x1 teeth at the tip; plain hemostatic forceps doesn't
Suggested Exam Answer Format
73."This is a [instrument name]."
74."Key identifying features are..." (2–3 parts)
75."It is used for..." (numbered, most important use first)
[Link] asked to draw: outline shape → label 2–3 parts → done (don't overdraw — OSCE stations are timed)
Source: DC Dutta's Textbook of Obstetrics, 9th ed. (pp. 612–623) — lecture slides by Mrs. Lakpa Doma Sherpa, Aliah University.