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DAILY FREE MCQ CHALLENGE for Medical PG Preparation
All of the following complications are more common in ventouse assisted delivery than forceps, Except:
A. Transient lateral rectus palsy
B. Intracranial hemorrhage
D. Subgaleal hemorrhage
TIPSImportant Question from AIIMS 2013
Answer: A. Transient lateral rectus palsy
Transient lateral rectus palsy is more common in forceps assisted delivery.Intracranial hemorrhage, cephalohematoma and subgaleal hemorrhage are more common in ventouse assisted delivery.
ADVANTAGES OF VENTOUSE OVER FORCEPS
ADVANTAGES OF FORCEPS OVER VENTOUSE
|It can be used in unrotated or malrotated head (OP, OT position). It helps in autorotation
||In Cases,where moderate traction is required,forceps will be more effective compared to ventouse
|It is not a space occupying device like the forceps blades
||Forceps operation can quickly expedite the delivery in case of fetal distress where ventouse will be unsuitable as it takes longer time
|Traction force is less (10 kg) compared to forceps
||It is safer in premature baby.The fetal head remains inside the protective cage
|It is comfortable and has lower rates of maternal trauma and genital tract lacerations
||It can be employed in anterior face or in after-coming head of breech presentation, where ventouse is contraindicated
|Analgesia need is less. Pudendal block with perineal infiltration is adequate but for forceps regional or general anesthesia is often needed
||Lesser neonatal scalp trauma,retinal hemorrhage,jaundice or cephalhematoma compared to ventouse
|Reduced maternal pelvic floor injuries and is advocated as the instrument of first choice.
||Higher rate of successful vaginal delivery as ventouse has got higher failure rates than forceps
|Perineal injury (3rd and 4th degree tears) are less compared to forceps
||Cup Detachment (“Pop-off”) occurs when the vacuum is not maintained in ventouse. No such problems once forceps blades are correctly applied
|Postpartum maternal discomfort (pain) are less compared to forceps
||Number of types of forceps (p. 572) are available for outlet, mid cavity or rotational delivery. Traction force is more (about 20kg for a primary and about 13 kg in a multi)
|Easier to learn comparing to forceps
Simplicity of use in delivery makes it convenient to the operator (suitable for trained midwives)
Reference: D.C.Dutta’s Textbook of Obstetrics 7th Ed, Page 581.
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