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!

E.M.Al-Awami

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

E.M.Al-Awami

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

E.M.Al-Awami

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

E.M.Al-Awami

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

E.M.Al-Awami

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