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Assisted Vaginal Birth
(GTG 26 - Apr 2020), Essential Conditions for…
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Essential Conditions for Assisted Delivery1. Full abdominal and vaginal examination
- Head is ≤ 1/5 palpable per abdomen (in most cases not palpable)
- Cervix is fully dilated and the membranes ruptured
- Station at level of ischial spines or below
- Position of the fetal head has been determined
- Caput and moulding is no more than moderate (or +2)
- Pelvis is deemed adequate
2. Preparation of the mother
- Clear explanation given and informed consent taken and documented in women’s case notes
- Trust established; full cooperation sought and agreed
- Maternal bladder has been emptied
- Indwelling catheter has been removed or balloon deflated
- Aseptic technique
3. Preparation of staff
- Operator has the knowledge, experience and skill necessary
- Adequate facilities are available (equipment, bed, lighting) and access to an operating theatre
- Backup plan: for midpelvic births, theatre facilities should be available to allow a caesarean birth to be performed without delay; a senior obstetrician should be present if an inexperienced obstetrician is conducting the birth
- Anticipation of complications that may arise (e.g. shoulder dystocia, perineal trauma, postpartum haemorrhage)
- Personnel present who are trained in neonatal resuscitation