Skill Lab

:Done by
 Nuney 
Placenta Increta
• Placenta Increta 
invasion

Uterine wall

Invasion of myometrium

Placenta previa centralis

covering the internal os

Cervix
• The other half of
the previous uterus.

A vessel ( just an opening )

• Another view from
another side.

Ovary

 ‫فلين‬
Placenta Increta

• Another placenta
with part of the
uterus..
Umbilical cord

Placenta

Part of the uterus

Fibroid
Multiple Fibroids
Tubal Ectopic Pregnancy
Vesicular Moles
Teratoma
The Uterus
• Hysterectomy

Intrauterine
device
*Short (wriglx) Forceps

• Traction of the head of the

baby in obstructed labor.
• To differentiate between
right & left:
‫لمن تمسكي باليمين الكونكافيتي تكون على فوق‬
‫ومن جوه‬..
‫ ****الدكتور اكمل قال اسمه‬wriglx or
low forceps‫ي كفيت قولي‬
*vorcellum Forceps

• Used to grasp the

cervix during
gynecological
procedure (can’t be
used in pregnant
ladies) so used in non
pregnant cervix
*Doyen retractor

• Traction of the
bladder & the
inferior peritoneal ….
To expose the lower
uterine segment in
C/S.
*Bivalve (Cusco’s) Speculum

• Vaginal speculum
• Used for exposure and
to visualize the cervix
and vagina in cases of
Inspection of cervix & .1
vagina (pap smear,
discharge, swab)
High vaginal swab .2
Confirm PROM .3
IUD insertion .4
‫‪*endometrial curette‬‬

‫‪• Used for currtage of‬‬

‫‪endometrium in D&C‬‬
‫فيه اتنين واحد ذهبي شكله •‬
‫مصدي والتاني فضي خخخخ‬
‫يعني عشان التلخبطوا‬
*Hegar dilator

• Used for dilatation

of endometrium in
D&C
• ‫موجود منه احجام مختلفة‬
*Needle Holder

• To hold the needle

of the suture.
*Sim’s Speculum

• Vaginal speculum
• Used to visualize the
cervix and vagina for
1. Inspect vaginal wall for
lesions (fistula,
prolapse, neoplasm)
2. D&C
3. Exploration in PPH
*Curved & straight artery forceps

• To ligate the
arteries.
• Used to hold
peritoneum and to
ligate
uterine artery.
• ‫الفرق بينه وبين السيزور‬
‫انه موجود فيه زي السنون‬
‫الصغيرة حادة‬
*Kidney shape plate
‫‪*Metal catheter‬‬
‫• الدكتور اكمل قال مو مهم‬
E.M.Al-Awami
 Forceps
Indications:
1.Fetal: distress, cord prolapse
2.Maternal:
blade
lock *shorten the 2nd stage (cardiac
disease, pul.edema,
hypertension, neurological
dysfunctions)
*Maternal exhaustion
*Poor maternal effort
3.Elective:
shank *After coming head in
handle breech.del.
*During caesarean section
E.M.Al-Awami
 Forceps
Pre-requisites:
Fetal: Maternal:
1. Cervix fully dilated
1. Head engaged ( station +2
or lower) 2. Membrane must be ruptured

2. Vertex or face presentation 3. No cephalopelvic disproportion

4. Bladder empty
3. Position of the fetus
precisely known 5. Adequate analgesia & anesthesia
6. Generous episiotomy
7. Lithotomic position
Contraindications are 8. Empty rectum
the opposite to them!E.M.Al-Awami
 Forceps
Complications:
Fetal: Maternal:
1. Facial n.or brachial 1. Tear and laceration of the
plexus injury cervix
2. Skull fractures
2. Rupture of bladder
3. Heamatoma (caput
saccundum) 3. Extension of episiotomy
4. Intracranial Hge 4. Bleeding
5. Infections

E.M.Al-Awami
 Types of forceps
a. Simpson b. piper

English lock Long shank

Traction forceps Delivery of after

E.M.Al-Awami
coming head in
breech
Types of forceps
c. Kielland

Rotational forceps

Sliding lock

E.M.Al-Awami
 *Vacuum extractor cup
Indications, Prerequisites
& Contraindications
Same as forceps.. PLUS
few more points !
Prerequisites:
• Full term baby
• Full flexion of the head
• Suction pressure < 600
mmHg
• Not more than 3
application
suction apparatus ‫فيه كمان‬
• Don’t twist the cup !
‫بس مش موجود في الصورة‬
ventose ‫يكفي تقولي‬
 Vacuum extractor cup

Contraindications: Complication:
1. Face or other than vertex 1. Vaginal laceration and
presentation fistula

2. Premature baby 2. Fetal scalp heamatoma,

laceration
3. Fetal coagulopathies
4. Fallowing fetal scalp
sampling!

E.M.Al-Awami
Pap’s smear set
Uses:
Obtain cytology smear
form the cervix and
vagina ( screening
purposes)

E.M.Al-Awami
 Components
Ayre’s spatula (2 ends)

slide
Endocervical swab fixator
E.M.Al-Awami
Swap for culture

Use:
1.Obtain swab form any
fluid or discharge
2.High vaginal swab

E.M.Al-Awami
Nitrzine test

• Looks like a swab

but has a yellow
head ..
• Used to confirm
rupture of membrane
Alkaline amniotic fluid

Yellow Blue

E.M.Al-Awami
Fetal scalp electrode
(internal monitor)
Uses:
Record fetal ECG by applying
small clip to fetal scalp.
Indications:
1. Chorioaminoitis
2. Meuconium stained liquor
3. Twins
4. Excessive fetal movement
5. Unsatisfactory CTG
6. High risk pregnancy

E.M.Al-Awami
 Fetal scalp electrode
Advantages: Contraindications:
More reliable tracing to fetal 1. Maternal infection e.g
heart beat & variability.. HIV, herpes simplex
2. Sever fetal coagulopathy
Disadvantages:
1. Rupture of membrane is a
must; spontaneous or
artificial
2. Little chance of infection;
mother & fetus
3. Scalp trauma E.M.Al-Awami
 Sponge forceps
(ovum forceps* without lock)
Ring Forceps (with lock)
‫هوا اللي موجود في السكل الب‬
‫ مشموجود‬Ovum forceps (without lock)

Curved Used to grasp the cervix during

gynecological procedure (can be used
.in pregnant)

Uses:
1. Remove conceptional
product, intrauterine,
cervical polyp
* Straight
2. To hold tissue e.g cervix
during D&C
Amni-hook perforator
Use: non pharmacological
induction of labor
(Rupture membrane)
Complication:
1. Fetal & maternal injuries
2. Cord prolapse
Sharp
3. Rupture of vasa previa
end
4. Chorioaminoitis

E.M.Al-Awami
 Amni-hook perforator

Advantages: Contraindications:
1. Accelerate labor 1. Intrauterine fetal death

2. Help see liquor 2. Maternal infections e.g

HIV, herpes simplex

E.M.Al-Awami
‫المحاضره هادي حقت بنات العام انا زودت عليها كم ساليدة من اللي شرحها‬
‫الدكتور اكمل‬
‫واللي شرحها حتالقوا فيها عالمة* والكالم ملون باللون االورنجي‬
‫واهم شي تعرفوا ‪name and use of each instrument‬‬
‫بس الباقي ماقاله‬
‫وسالمتكم‬
‫‪BEST WISHES‬‬
‫‪Dr.Mano‬‬