Gynecological and Obstetric Instruments

Gynaecological & Obstetric Instruments

CUSCO”S (BIVALVE) SPECULUM
Gynaecological Indications:
1-Examination of vagina & cervix in cases of abnormal vaginal bleeding
2-To take cervical smear for cervical cancer screening.
3-To insert or to remove IUCD.
4-To take vaginal & cervical swab to exclude infections.
5-To allow introduction of uterine sound.
Obstetric Indications:
1-To diagnose PROM in cases with H/O watery vaginal discharge & also to exclude cord prolapse.
2-To exclude local causes of APH.

SIM”S SPECULUM

Indications:
1-To exam the anterior vaginal wall for diagnosis of vesico-vaginal fistula.
2-To diagnose pelvic organ prolapse.
3-To expose the vaginal for fistula repair.
N.B:
Sim”s speculum need assistant during examination
of the vagina & the patient should be in left lateral
position or Sim”s position.

UTERINE CURETTE

Indications:
1-To take an endometrial sample in cases of abnormal vaginal bleeding
2-To detect ovulation in cases of infertility by detection of secretory change of endometrium
3-To remove the decidua (curetage) after evacuation in case of abortion&molar pregnancy.
4-To remove retained products of conception in cases of PPH.
Complications:
1-Permanent amenorrhea & infertility due to removal of basal layer of endometrium.
2-Asherman”ssyndrome.
3-Endomeriosis due to implantation of endometrial tissue in the vagina or perineal scar.
4-Complications of dilatation (cervical trauma).

UTERINE SOUND

Indications:
1-To measure the length of the uterine cavity.
2-To know the position & direction of the uterus in case of retroversion.
3-To differentiate between a polyp arising from the cervical canal or body of the uterus.
4-To measure the length of the cervical canal.
Complications:
1-Shock due to pain. 2-Ascending infections.
3-Perforation of the uterus. 4-Abortion if introduced into a pregnant uterus.

double end Single end

Indications:
1-To dilate the cervix for under GA or paracervical block:
a-induction of labour b-taking cervical biopsy c-curettage d-hysteroscopy
2-To diagnose cx-incompetence when Hegar”s no. 8 passe easily without pain&resistant
Complications:
1-Cercical trauma that may lead to cervical incompetence ,uterine perforation.
2-Bleeding due to cervical lacerations.
There is different sizes from 3-12 mm ,no. 7-10 for curettage.
HEGAR”S DILATOR

RUBIN”S CANNULA

Indications:
To inject a dye into the cervix to perform hysterosalpingogram (HSG) to detect patency of Fallopian tubes in cases of infertility & also for diagnosis of: cervical incompetence ,congenital anomalies of the uterus ,Asherman”s syndrome.

Ventous for vacuum delivary

Indication :
1-delay second labour stage 2- fetal distress
Requirment :
1- cx full dilators 2- fetal head engagment 3- good uterus contraction
C\ I :
1- fetal scalp bleeding 2- <34 wk g 3- malepresentation
If ventous failed don’t try forecepe or repeat ventous twice

long curved forceps

Indications:
1_ Maternal exhaustion 2_ Prolonged second stage
3_ occipito posterior position 4_ After-coming head in breech delivery

OVUM FORCEPS

Indications:
1-To remove products of conception. 2-To evacuate the uterus after abortion.
Complications:
Perforation of the uterus.
It has no lock.

VULSELLUM FORCEPS

Indications:
1-To grasp the cervical lips to visualize the cervix or during vaginal hysterectomy .
2-To grasp a fibroid polyp during vaginal myomectomy.
N.B:
-It may be single-toothed ,double-toothed or multiple-toothed.
-Should not used during pregnancy due to risk of bleeding.
-It causes laceration of the cervix causing bleeding.

SPONGE HOLDER FORCEPS

Indications:

1-To hold gauzes during sterilization & cleaning of skin before surgery.
2-For removal of IUCD.
3-To grasp the ant. Cervical lip during removal of product of conception as vulsellum forceps causes bleeding due to high vascularity of the cervix during the pregnancy.
N.B: It has a lock.

KOHER”S FORCEPS

Indications:
1-To perform artificial rupture of membranes (ARM) for induction of labour.
2-To hold sheaths of rectus muscle during C-section.
N.B:
It has toothed ends ,one end with single tooth & other end with two teeth. It has a lock.

PAPICOCK FORCEPS

Indications:
To hold soft tissues like bowel ,appendix or Fallopian tubes during abdominal surgery.

PINARD”S FETO-STETHOSCPOE

Indications:
To auscultate fetal heart sound.

Indications:

1-To hold peritoneum during c-section.
2-To remove a cervical polyp,
3-During tubal ligation & abdominal hysterectomy
N.B: It has a lock & toothed ends (3 teeth on one end & 2 teeth on the other).
ALLIES”S FORCEPS