Women will always choose the type of delivery that seems safest for them and their babies. If women choose a type of delivery that we disagree with then either they may be right and we may be wrong, the care…
Introduction Uterine rupture is an infrequent, life-threatening obstetric complication for the mother and the fetus, which is often related to a previous caesarean delivery. Although it has been described in nulliparous women, uterine rupture is generally a complication of multiparous…
Once a Caesarean Always a Caesarean ‘One thing must always be borne in mind, viz., that no matter how carefully a uterine incision is sutured, we can never be certain that the cicatrized uterine wall will stand a subsequent pregnancy…
On Twins: ‘It is a constant rule, to keep patients, who have born one child, ignorant of there being another, as long as it can possibly be done’. Thomas Denman An Introduction to the Practice of Midwifery. London: J. Johnston,…
Epidemiology Breech presentation is a normal variant, occurring in up to 4% of term and 25% of preterm births. It is more common in nulliparous women (60%), where there are uterine or fetal abnormalities, placental praevia or another pelvic obstruction,…
‘… time passes. The child’s face becomes suffused. It endeavours unsuccessfully to breathe. Abdominal efforts by the mother or by her attendants produce no advance, gentle head traction is equally unavailing. Usually equanimity forsakes the attendants. They push, they pull.…
Rotational Forceps – Historical Context The development of nonrotational forceps, manual rotation and vacuum as part of the obstetric armamentarium has been described in the previous three chapters. Obstetric forceps required adaptation in order to achieve rotation within the confines…
The Vacuum Extractor – Historical Context The use of the vacuum extractor in high-income countries has increased, so that a majority of assisted vaginal deliveries globally are now performed using this instrument as opposed to the obstetric forceps. The vacuum…
The Forceps – Historical Context The invention of the forceps by the Chamberlen family and how the instruments were initially used has been described in Chapter 15 . The addition of the pelvic curve to the design of the forceps…
Introduction Assisted vaginal delivery (AVD) remains, in skilled hands, the most efficient method of expediting birth in the second stage of labour and is associated with fewer adverse maternal and neonatal outcomes than any alternative. This chapter will focus on…