Question

4. What is version and what are the contraindications of this procedure? 5. List and describe the types of perineal lacerations and episiotomies. 6. Under what conditions are obstetric forceps and vacuum extractors used? 7. What conditions may indicate a cesarean delivery? 8. What is hypertonic labor, and how is it treated? 9. Identify the most common factors that can increase stress and cause dystocia during the labor process. 10. Describe the medical treatment for uterine inversion.

Answer 1

Ans) 4) External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginel birth.

- Relative contraindications include maternal obesity, small for gestational age fetus (less than 10%), and oligohydramnios because they make successful ECV less likely. Previous uterine scar from cesarean delivery or myomectomy may also be a relative contraindication for ECV.

5) Perineal laceration:

The different severity of lacerations
first degree, second degree, third degree, fourth degree
First degree: Type of laceration is limited to the perineal skin and vaginel mucous membrane.

Second degree: Type of laceration involves the perineal sking, vaginel mucous membrane and muscles of the perineum.

Third degree: Type of laceration extends through the perineal skin, vaginel mucous membranes, perineum and anal sphincter.

Fourth degree: Type of laceration extends through the rectal mucosa to the lumen of the rectum.

Types of lacerations:
- vaginel, urethral lacerations, cervical injuries

- The type of laceration extends to the walls of the vagine- vaginel lacerations.

- A tear that extends down to the walls of the vagine are called sulcus tear.

- This type of laceration extends up to the urethra- Urethral lacerations.

Types of episiotomies:
- midline, mediolateral
- Midline: Most common episiotomy and least painful, but more likely to extend to a 3rd/4th degree laceration.

- Mediolateral: Episiotomy has more blood loss and is more painful, will need adequate anesthesia for the repair.

6)Obstetrical forceps are an instrument that can be used to assist in the delivery of a baby as an alternative to the ventouse method.

Vacuum extraction (VE), also known as ventouse, is a method to assist delivery of a baby using a vacuum device. It is used in the second stage of labor if it has not progressed adequately. It may be an alternative to a forceps delivery and caesarean section.

7) The most common indications for primary cesarean delivery include labor dystocia, abnormal or indeterminate fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia.