Show Notes
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
