Forceps

The forceps used to be the only device used to pull the live fetus, which is difficult to grasp than the fetal head attractor. If used improperly, it can cause maternal and child trauma. At present, most applications are considered when the fetal head aspiration is unsuccessful. Treatment of diseases: placenta premature anterior placenta Indication The uterus is weak, the second stage of labor is prolonged; suffering from heart disease, tuberculosis, pregnancy-induced hypertension or previous cesarean section, etc., should not be excessively exerted during birth; placenta previa, placental abruption, umbilical cord prolapse and fetal palace Internal asphyxia, etc.; persistent occipital position, childbirth progress is too slow; cesarean section fetal head delivery difficulties, can be assisted with forceps. Contraindications Pelvic stenosis or head basin is not called; forehead, high orthodontic or other abnormal fetal position; severe fetal distress, it is estimated that the forceps can not immediately end the delivery; the palace mouth is not open. Preoperative preparation The same attraction. All need to cut the side of the perineum, and the incision should be large. Surgical procedure The forceps are divided into two left and right leaves. When operating, the left hand holds the left leaf and is placed on the left side of the maternal pelvis. The right leaf is reversed. The operation is divided into several steps of placing, closing, pulling and lowering the forceps. Urinary catheterization must be performed before surgery. Now take the occipital forceps as an example. (1) Place the instrument and check the instrument before placing it. Put the left leaf of the forceps first, and then place the right leaf to buckle. Hold the right leaf with your left hand, apply a lubricant, guide your right hand, and slowly feed it into the vagina. If the position of the child is low, use the food and the middle finger to guide. If the position is higher, the majority of the hand must be extended into the vagina for guidance. When the insertion is started, the forceps are perpendicular to the ground, and the concave surface of the forceps faces the perineum, and is gently inserted through the posterior wall of the vagina. Under the influence of the right hand, the curvature of the pelvic pelvis slowly advances, and the side moves to the left side of the pelvis and is placed. The left side of the fetal head. After putting it out, take out the right hand. At this time, the petiole is parallel to the ground. It can be held by the ring finger and little finger of the left hand or by the assistant. Then, in the same way, hold the right leaf of the forceps with your right hand and slowly feed it into the vagina under the guidance of the left hand, placing it on the right side of the head. (2) Closing, if the two leaves are properly placed, they can be smoothly closed. Otherwise, they can be moved forward and backward to make them close together, and the distance between the two handles should be kept at about one fingertip width. Do not lean close to avoid excessive compression of the tires. head. If the closing is not easy, indicating that the placement is not appropriate, the playback should be taken out. After closing, pay attention to the fetal heart sound. If there is a sudden change, it may be too tight or because the umbilical cord is clamped. The detailed examination should be released. (3) Traction and lower jaws. If the fetal heart sounds are normal after closing, traction can begin. Traction should be carried out during the contraction, the force should be gradually strengthened with the contraction, and then gradually weakened. During the interval of the contraction, the forceps should be loosened to reduce the pressure on the head and pay attention to the heart sound of the tire. The direction of traction changes with the head down. Start the clamp handle parallel to the ground (the head position should be higher, should be pulled down slightly), and the two hands should be forced in the direction shown. When the occipital part appears under the pubic arch and the perineum is obviously bulging, it can be slowly lifted up with one hand, and the child's head is lifted out. After the head is "crowned", the forceps can be removed. The order of taking the pliers is the opposite of that when placing it. First, the right lobe is placed, then the left lobe is placed, and then the head is delivered by hand. Pay attention to protect the perineum.