Procedure Ready: Ob/Gyn

Operative Vaginal Deliveries

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Incidence: 

3.3% as of 2013 

Indications: 

  • Prolonged second stage 
  • Risk of fetal compromise 
  • Shortening 2nd stage for maternal benefit (ex: cardiac conditions)

    • Consent: 

    • Comparison is c-section typically 
    • Failure rate of OVD is ~3-6% 
    • Forceps has higher success rate over vacuum, but also higher risk 3rd/4th degree tear 
    • Risks to both mom and baby

      • Prep: 

      • Fetus appropriate station/position 
      • Anesthesia
      • Empty bladder
      • Assess Pelvis/Passenger sizes/fit
      • OR Ready
      • Peds available 

        • Episiotomy – NO! 

        Contraindications

        • Fetal conditions, known or supspected: bone disorders (OI), bleeding disorders 
        • Maternal infections: Hep C, HIV, etc 
        • Concern for shoulder dystocia/cephalo-pelvic dysproportion 
          • ...more
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          Procedure Ready: Ob/GynBy Jennifer Doorey, MD, MS
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