Instruments OBS &

GYNAE

UMAR IQBAL SALEEMI

SIMS SPECULUM

USES:
1) Use in Gynaecological OPD for following procedures:
 Taking Pap Smear
 Insertion and removal of Copper T
 Colposcopy
 Hyseterosalpingography(HSG)

2) Use in Gynaecological Operations:

 D&C
 Cervix Biopsy
 Vaginal Hysterectomy
 Repair of Vesicovaginal fistula
 Hysteroscopy

3) Use in Obstetrics:
 Os tightening or cervical circalage
 Removal of os tightening stitch at the onset of labor at 38 weeks
 Inspection for suspected rupture of membranes.
 After forceps delivery to trace for cervical tears.
CUSCO’S SPECULUM

USES:
1) Gynaecological Indications:
 Examination of vagina & cervix in cases of abnormal vaginal
bleeding
 To take cervical smear for cervical cancer screening.
 To insert or to remove IUCD.
 To take vaginal & cervical swab to exclude infections.
 To allow introduction of uterine sound.
2) Obstetric Indications:
 To diagnose PROM in cases with H/O watery vaginal discharge &
also to exclude cord prolapse.
 To exclude local causes of APH.
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) Ascending infections.
2) Perforation of the uterus
3) Abortion if introduced into a pregnant uterus.
UTERINE CURRETE

Indications:
1) To take an endometrial sample in cases of abnormal vaginal bleeding
2) To remove the decidua (curettage) after evacuation in case of abortion
and molar pregnancy.
3) 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’s syndrome.
3) Endometriosis due to implantation of endometrial tissue in the vagina
or perineal scar.
4) Complications of dilatation (cervical trauma)
HEGAR’S UTERINE DILATOR

Indications:
1) To dilate the cervix
 induction of labour
 taking cervical biopsy
 D&C
 Hysteroscopy
2) To diagnose cervical incompetence when Hegar’s no. 8 passes easily
without pain and resistance
Complications:
1) Cervical trauma that may lead to cervical incompetence, uterine
perforation.
2) Bleeding due to cervical lacerations.
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

PINARDS FETAL STETHOSCOPE

 To auscultate fetal heart sound

Ayre's Spatula

USES:
Use for taking Pap smear for screening of carcinoma cervix.
Green Armytage Forceps

Use:
 This forceps is used as a hemostat in caesarean operation. As
the tips are broad wide area can be compressed.
 In LSCS the cut uterine edges bleed. This forceps is applied to
the two angles and lower and upper edge of the incision.
Volsellum forceps

USES:
1) To hold anterior lip of Cervix
2) To hold posterior lip of Cervix
3) Cervical stump in subtotal hysterectomy
Complications:
1) It causes laceration of the cervix causing bleeding.
Tenaculum forceps

USE:
 To hold of vault or cervix during major gynecological procedures like
abdominal hysterectomy
Doyen’s retractor

USES:
1) This instrument is used for retracting bladder during abdominal
operations like LSCS, abdominal hysterectomy, laparotomy.
2) The smooth edge and the curvature retracts the bladder and protects it
during surgery
Myoma screw

Uses:
 To hold the fundus of uterus in myomectomy & hysterectomy
Ventouse suction cup

Indications:
1) Maternal exhaustion
2) Prolonged second stage of labor
3) Fetal distress in the second stage of labor, generally indicated by
changes in the fetal heart-rate (usually measured on a CTG)
4) Maternal illness where prolonged "bearing down" or pushing efforts
would be risky (e.g. cardiac conditions, blood pressure, aneurysm,
glaucoma).
Contraindications:
1) Gestations of less than 35 completed weeks because of the risk of
cephalohaematoma and intracranial hemorrhage.
2) face or breech presentation
Complications:
1) Fails to achieve a vaginal delivery
2) Cephalohaematoma (sub periosteal bleed)
3) Retinal hemorrhage
4) maternal worries about the baby

DELIVERY FORCEPS
Types:
1) Non-rotational forceps are used when the head is occipitoanterior.
Examples such as Neville Barnes or Simpson forceps have a pelvic
curve and an English or non-sliding lock.
2) Rotational forceps ,such as Kielland forceps, have minimal pelvic
curve to allow rotation around a fixed axis

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

Prerequisites for any instrumental delivery:

1) Confirmed rupture of the membranes.
2) The cervix must be fully dilated
3) Vertex presentation with identification of the position.
For occipitoanterior and transverse positions, no part
 Of the fetal head should be palpable abdominally. For occipito-
posterior positions, it is acceptable that one-fifth of the head may
be palpable.
4) The presenting part should be at _1 or more below the ischial
spines.
5) Adequate analgesia/anesthesia.
6) Empty bladder/no obstruction below the fetal head contracted
pelvis/pelvic kidney/ovarian cyst, etc.)
7) A knowledgeable and experienced operator with adequate
8) Preparation to proceed with an alternative approach if necessary.
9) An adequately informed and consented patient (consent
Must be sought though not necessarily written).

Episiotomy scissor

Complications:
Hematoma, infection
Sponge holding forcep:

USES:
1) Hold the pregnant uterus (less traumatic than volsellum forceps )
2) In traumatic PPH (walking around cervix) atleast3 sponge ( one at 12
0 clock position & other to look for trauma) holding forceps to
visualize Cervix
3) Cleaning & draping in surgical procedures
ALLLIS FORCEP

Uses:
1) This is used for grasping tough structures like Rectus sheath or fascia
in operations like tubectomy , LSCS, abdominal hysterectomy
2) To hold peritoneum during C-section.
3) To remove a cervical polyp