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Abstract

Vaginal operative delivery

Vaginal operative delivery involves the extraction of the fetus by traction on its head. In some cases, this may also involve correcting the fetal attitude and position. Whether an operative delivery is appropriate depends on the circumstances of the labor, the informed consent of the mother, and the relevant experience and ability of the obstetrician. Because vaginal operative births can cause severe trauma to mother and child, it is generally accepted that they should be avoided when possible. The option of completely eliminating assisted vaginal delivery is, however, unreasonable, as there are situations in obstetrics in which such deliveries would be less traumatic and safer for mother and child then a cesarean section or allowing the labor to continue. In general, the degree of risk that accrues to mother and child are directly proportional to how high the head of the fetus lies in the birth canal when the delivery has begun, and to how much the sagittal suture deviates from the anteroposterior axis of the pelvis at that time. Operative delivery should be resorted to only when necessary, and mid-cavity deliveries should be carried out only by qualified and experienced obstetricians.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2015; 11(2): 140–158

Keywords
Operative vaginal delivery, prerequisites, performing, choice of instruments, complications

Hartmut Hopp
Klinik für Geburtsmedizin, Charité – Universitätsmedizin Berlin
Reviewer: Bernd Hüneke, Hamburg,
und Neslisah Yilmaz-Terzioglu, Nürnberg

Hopp H. Vaginal-operative ... Gynakol Geburtsmed Gynakol Endokrinol 2015; 11(2): 140–158 publiziert 31.07.2015 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2015 ISSN 1614-8533