1-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
INSTRUMENTS
TABLE:
Identification:
Main Points: SIMPLE RUBBER CATHETER
Identification Indications:
Indications Retention of urine: It is used to empty the
bladder.
A. during:
(a) Pregnancy: Retroverted Gravid Uterus.
(b) Labor:
When the woman fails to pass urine by herself
Before and after any operative interventions
(forceps delivery, destructive operations).
(c) Postpartum:
During management of postpartum
hemorrhage,
Retained placenta.
B. Other uses:
As a tourniquet,
To administer O2 when nasal catheter is not
SIMPLE RUBBER CATHETER available,
As a mucus sucker: When it is attached to a
mechanical or electric sucker.
TABLE:
Main Points: Identification:
Identification FOLEY’s Catheter
Indications Indications:
It is used for continuous drainage of bladder in
cases with:
Eclampsia
Retroverted gravid uterus
To give rest to the bladder following any
destructive operation and/ or in a case with
suspected bladder injury
It is usually kept for 7–10 days.
In the management of atonic PPH
To control atonic PPH.
FOLEY’s Catheter
2-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification SIMS’ DOUBLE BLADED POSTERIOR VAGINAL
Indications SPECULUM
Indications:
It is used in obstetrics:
To inspect the cervix and vagina and to detect
any injury following delivery
To clean the vagina following delivery.
To inspect the cervix and vagina to exclude any
local cause for bleeding in APH (Cusco’s
speculum preferred).
During D & E operation.
SIMS’ DOUBLE BLADED POSTERIOR VAGINAL
SPECULUM
TABLE:
Main Points: Identification:
Identification CUSCO’S BIVALVE SELF RETAINING VAGINAL
Indications SPECULUM
Indications:
To visualize the cervix and vaginal fornices for
any local cause (polyp, ectopy) of APH
To inspect the cervix and to prepare cervical
smear for cytology screening
To detect leakage of liqor from the cervical os
in a case of suspected PROM.
CUSCO’S BIVALVE SELF RETAINING VAGINAL
SPECULUM
3-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification MULTIPLE TOOTHED VULSELLUM:
Indications Indications:
It is used to catch hold the anterior lip of the
cervix in:
D + E operation,
Suction evacuation
As it produces trauma to the soft and vascular
cervix, Allis tissue forceps is used instead.
MULTIPLE TOOTHED VULSELLUM
TABLE:
Main Points: Identification:
Identification ALLIS TISSUE FORCEPS
Indications Indications:
To catch hold the anterior lip of the cervix in D
+ E operation
To hold the apex of the episiotomy wound
during repair
To catch hold of the margins of the
peritoneum, rectus sheath, vaginal mucosa
during repair.
To catch hold of the torn ends of the sphincter
ani externus prior to suture in repair of
ALLIS TISSUE FORCEPS complete perineal tear.
To catch hold the margins and angles of the
uterine flaps in LSCS after the delivery of the
baby as an alternative to Green-Armytage
hemostatic clamp
TABLE:
Main Points: Identification:
Identification LONG STRAIGHT HEMOSTATIC FORCEPS
Indications Indications:
This is not commonly used in obstetrics.
It can be used to clamp the pedicle while
removing the uterus as in rupture uterus.
The umbilical cord may be clamped as an
alternative to Kocher’s.
LONG STRAIGHT HEMOSTATIC FORCEPS
4-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification KOCHER’S HEMOSTATIC FORCEPS
Indications Indications:
To clamp the umbilical cord—for better grip
and effective crushing effect to occlude the
vessels.
In low rupture of the membranes as surgical
induction of labor or augmentation of labor
KOCHER’S HEMOSTATIC FORCEPS
TABLE:
Main Points: Identification:
Identification LONG STRAIGHT SCISSORS
Indications Indications:
It is commonly used to cut the:
Umbilical cord
To make episiotomy
To cut suture materials as in cesarean section
LONG STRAIGHT SCISSORS
TABLE:
Main Points: Identification:
Identification UTERINE SOUND
Indications Indications:
To know the position of the uterus and the
length of the uterine cavity prior to dilatation
of the cervix in D + E operation.
To sound the uterine cavity to detect any
foreign body (IUCD).
It acts as a first dilator of the cervical canal
UTERINE SOUND
5-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification A and B CERVICAL DILATORS
Indications Indications:
It is used in dilatation of the cervical canal
prior to evacuation operation.
A and B CERVICAL DILATORS
TABLE:
Main Points: Identification:
Identification FLUSHING CURETTE
Indications Indications:
It is a blunt curette used in the operation of D
+ E.
Previously, it was used to flush the uterine
cavity with lukewarm antiseptic solution—
passing through the communicating channel.
FLUSHING CURETTE
TABLE:
Main Points: Identification:
Identification DOYEN’S RETRACTOR
Indications Indications:
It is used to retract the abdominal wall as well
as the bladder for proper exposure of lower
uterine segment during LSCS.
It is to be introduced after opening the
abdomen; to be temporarily taken off while
the baby is delivered, to be reintroduced after
delivery of the baby and finally to be removed
after toileting the peritoneal cavity.
DOYEN’S RETRACTOR
6-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification SPONGE HOLDING FORCEPS
Indications Indications:
Toileting the vulva, vagina and perineum prior
to and following delivery.
Antiseptic painting of the abdominal wall prior
to cesarean section.
To catch hold the membranes if it threatens to
tear during delivery of the placenta.
To catch hold the cervix (2 pairs are needed)
for inspection in suspected cervical tear.
SPONGE HOLDING FORCEPS To catch hold the cervix during encirclage
operation
TABLE:
Main Points: Identification:
Identification OVUM FORCEPS
Indications Indications:
It has got no catch and the blades are slightly
bent and fenestrated. Absence of catch
minimizes uterine injury, if accidentally caught.
It prevents crushing of the conceptus. It is to
be introduced with the blades closed, to open
up inside the uterine cavity, to grasp the
products and to take out the instrument with a
slight rotatory movement.
The rotatory movements not only facilitate
OVUM FORCEPS detachment of the products from the uterine
wall but also minimize the injury of the uterine
wall, if accidentally grasped.
TABLE:
Main Points: Identification:
Identification UTERINE CURETTE
Indications Indications:
It may be sharp at both ends or sharp at one
end and blunt at the other.
Its common use in obstetrics is in the
operation of D + C for incomplete abortion.
In D + E operation, the curettage is done by
blunt curette as the uterine wall is very soft.
It can also be used in D + C operation one
week following evacuation of hydatidiform
mole.
UTERINE CURETTE
7-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification UTERINE DRESSING FORCEPS
Indications Indications:
It is used:
To swab the uterine cavity following D + E with
small gauze pieces
To dilate the cervix in lochiometra or
pyometra
UTERINE DRESSING FORCEPS
TABLE:
Main Points: Identification:
Identification LAMINARIA TENT AND THE TENT INTRODUCING
Indications FORCEPS WITH LAMINARIA TENT
Indications:
The instrument is almost similar to uterine
dressing forceps. There is a groove on either
blade to catch the laminaria tent
LAMINARIA TENT AND THE TENT INTRODUCING
FORCEPS WITH LAMINARIA TENT
TABLE:
Main Points: Identification:
Identification LONG CURVED OBSTETRIC FORCEPS
Indications Indications:
It is commonly used in low forceps operation
LONG CURVED OBSTETRIC FORCEPS
8-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification SHORT CURVED OBSTETRIC FORCEPS (WRIGLEY’S
Indications FORCEPS
Indications:
It can only be used as outlet forceps for
extraction of the head
SHORT CURVED OBSTETRIC FORCEPS (WRIGLEY’S
FORCEPS
TABLE:
Main Points: Identification:
Identification KIELLAND’S FORCEPS
Indications Indications:
It is usually used as rotation forceps in deep
transverse arrest of occipito-posterior position
of the head or in unrotated vertex or face
presentation
KIELLAND’S FORCEPS
TABLE:
Main Points: Identification:
Identification FORCEPS’ AXIS TRACTION DEVICES
Indications Indications:
It includes axis traction rods (right and left)
and handle.
The rods are assembled in the blades of long-
curved obstetric forceps prior to introduction
and lastly the handle is attached to the rods.
The devices are required where many forces
are necessary for traction as in mid forceps
operation. These are less commonly used now.
FORCEPS’ AXIS TRACTION DEVICES
9-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification EPISIOTOMY SCISSORS
Indications Indications:
It is bent on edge.
The blade with blunt tip goes inside the vagina.
EPISIOTOMY SCISSORS
TABLE:
Main Points: Identification:
Identification VENTOUSE CUP WITH TRACTION DEVICE
Indications Indications:
It is used in the operation of vacuum
extraction of the head.
The cup is to be fitted to the scalp of the
forecoming head by producing “chignon” with
the help of vacuum.
The cup has got various sizes
VENTOUSE CUP WITH TRACTION DEVICE
10-Page [Dr Muhammad Ishaq Yousafzai (Swati), Hamdard college of Medicine & Dentistry, Batch:22
TABLE:
Main Points: Identification:
Identification GREEN–ARMYTAGE HEMOSTATIC FORCEPS
Indications Indications:
It is used in lower segment cesarean section.
Total four forceps are ordinarily required—one
for each angle and one for each flap.
Its functions are hemostasis and to catch hold
of the margins so that they are not missed
during suture.
It cannot be used in classical cesarean section.
Alternative to this Allis tissue forceps may be
GREEN–ARMYTAGE HEMOSTATIC FORCEPS used.
TABLE:
Main Points: Identification:
Identification PINARD’S STETHOSCOPE
Indications Indications:
It should be held firmly at right angle to the
point on the abdominal wall.
The ear must be firmly closed to the aural end.
It should not be touched by hand while
listening.
PINARD’S STETHOSCOPE
TABLE:
Main Points: Identification:
Identification GIANT VULSELLUM
Indications Indications:
It is used in destructive operation specially in
evisceration to have a good grip of the fetal
parts for giving traction.
GIANT VULSELLUM
Refrence:
DC Dutta, Jiralal konar: DC Dutta’s Textbook of OBSTETRICS, 42/Chp, p747-757, 3/e, Jaypee Brothers Medical Publishers (P)
Ltd, 2015.