Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about instrumental deliveries.

And you can find written notes on this topic at zero to finals.com slash instrumental delivery

or in the Labor and Delivery section of the Zero to Finals, Obstetrics and Gynaecology

book. So let's get straight into it. Instrumental delivery refers to a vaginal delivery

assisted by either a Vontuse suction cup or forceps. Tools are used to help deliver the baby's head. About 10% of births

in the UK are assisted by an instrumental delivery. An instrumental delivery can usually be

carried out on the labour ward. However, if there are concerns about whether it will be successful,

the woman may be moved to theatre so that rapid delivery by caesarian section can be performed

if necessary. A single dose of koamoxiclav, a broad spectrum antibiotic, is recommended after an instrumental delivery to reduce the risk of infection in the mother.

Let's talk about the indications. The decision to perform an instrumental delivery is based on the

clinical judgment of the midwife or obstetrician.

Some key indications are failure to progress,

fetal distress,

maternal exhaustion,

and to control the head of the fetus in various fetal positions.

The tom tip for you is worth remembering that there's an increased risk of requiring an instrumental delivery when an epidural is in place for analgesia.

Next let's talk about the risks. Having an instrumental delivery increases the risk to the mother

of postpartum hemorrhage,

requiring an apisiotomy, perineal tears, injury to the anal sphincter, incontinence of the bladder

or bowel in the future, and nerve injury affecting the obtrator or the femoral nerve.

The key risks to remember to the baby are a Cephalo haematoma or a large hematoma on the head

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