Obstetric Instruments: Sims' Double Bladed Posterior Vaginal Speculum

OBSTETRIC INSTRUMENTS
SIMS’ DOUBLE BLADED POSTERIOR VAGINAL SPECULUM:
 The blades are of unequal breadth to facilitate introduction into the vagina depending
upon the space available (narrow blade in nulliparous and the wider blade in parous
women).
It is used in obstetrics:
(1) To inspect the cervix and vagina and to detect any injury following delivery.
(2) To clean the vagina following delivery.
(3) To inspect the cervix and vagina to exclude any local cause for bleeding in APH
(Cusco’s speculum preferred).
(4) During D & E operation.
CUSCO’S BIVALVE SELF RETAINING VAGINAL
SPECULUM
Uses:
i) To visualize the cervix and vaginal fornices for any local cause of APH.
(ii) To inspect the cervix and to prepare cervical smear for cytology screening. (iii) To
detect leakage of liqor from the cervical os in a case of suspected PROM.
MULTIPLE TOOTHED VULSELLUM

Uses:
It is used to catch hold the anterior lip of the cervix in (a) D + E operation, (b) suction
evacuation
. • As it produces trauma to the soft and vascular cervix, Allis tissue forceps is used instead.
ALLIS TISSUE FORCEPS

Uses:
(1) To catch hold the anterior lip of the cervix in D + E operation.
(2) To hold the apex of the episiotomy wound during repair. •
(3) To catch hold of the margins of the peritoneum, rectus sheath, vaginal mucosa during repair.
(4) To catch hold of the torn ends of the sphincter aniexternus prior to suture in repair of
complete perineal tear.
(5) To catch hold the margins and angles of the uterine flaps in LSCS after the delivery of the
baby as an alternative to Green-Armytage hemostatic clamp.
KOCHER’S HEMOSTATIC FORCEPS
Uses:
(1) To clamp the umbilical cord—for better grip and effective crushing effect to occlude the
vessels.
(2) In low rupture of the membranes as surgical induction of labor or augmentation of labor.
UTERINE SOUND
Uses
 It is an olive pointed, graduated, malleable, metallic uterine sound.

 (i) To know the position of the uterus and the length of the uterine cavity prior to
dilatation of the cervix in D + E operation.
 (ii) To sound the uterine cavity to detect any foreign body (IUCD).
 (iii) It acts as a first dilator of the cervical canal.
FLUSHING CURETTE
 It is a blunt curette used in the operation of D + E. Previously, it was used to flush the
uterine cavity with lukewarm antiseptic solution— passing through the communicating
channel
DOYEN’S RETRACTOR
Uses
 It is used to retract the abdominal wall as well as the bladder for proper exposure of lower
uterine segment during LSCS.
 It is to be introduced after opening the abdomen; to be temporarily taken off while the
baby is delivered, to be reintroduced after delivery of the baby and finally to be removed
after toileting the peritoneal cavity.
SPONGE HOLDING FORCEPS
Uses:
(1) Toileting the vulva, vagina and perineum prior to and following
delivery.
(2) Antiseptic painting of the abdominal wall prior to cesarean
section.
(3) To catch hold the membranes if it threatens to tear during
delivery of the placenta.
(4) To catch hold the cervix (2 pairs are needed) for inspection in
suspected cervical tear.
(5) To catch hold the cervix during encirclage operation
OVUM FORCEPS:
 It has got no catch and the blades are slightly bent and fenestrated.
 Absence of catch minimizes uterine injury, if accidentally caught. It
prevents crushing of the conceptus.
• It is to be introduced with the blades closed, to open up inside the uterine cavity, to grasp
the products and to take out the instrument with a slight rotatory movement.
• The rotatory movements not only facilitate detachment of the products from the uterine
wall but also minimize the injury of the uterine wall, if accidentally grasped.
MANUAL VACUUM ASPIRATION (MVA)

SYRINGE
Use: This is used for evacuation of the uterus by creating a vacuum.
It is used up to 12 weeks of pregnancy.
Advantages of MVA:
(i) It is simple,
(ii) safe,
(iii) can be done as an outpatient basis,
(iv) with local anesthesia,
(v) effective (98%),
(vi) less traumatic and
(vii) it takes less time (10–15 min).
LONG CURVED OBSTETRIC FORCEPS

Uses:It is commonly used in low forceps operation
SHORT CURVED OBSTETRIC FORCEPS
Uses:It can only be used as outlet forceps for extraction of the head
KIELLAND’S FORCEPS
USES:
It is usually used as rotation forceps in deep transverse arrest of occipito-posterior position of
the head or in unrotated vertex or face presentation
EPISIOTOMY SCISSORS
USES:
It is bent on edge. The blade with blunt tip goes inside the vagina
CORD-CLAMP (DISPOSABLE)
USES:It is made of plastic and is supplied in a sterile pack. The serrated surface and the lock
make its grip firm. It occludes the umbilical vessels effectively. The cord clamp is to be kept in
place until it falls off together with the detached stump of umbilical cord.

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OBSTETRIC INSTRUMENTS

SIMS’ DOUBLE BLADED POSTERIOR VAGINAL SPECULUM:

MULTIPLE TOOTHED VULSELLUM

ALLIS TISSUE FORCEPS

(1) To catch hold the anterior lip of the cervix in D + E operation.

(2) To hold the apex of the episiotomy wound during repair. •

 It is an olive pointed, graduated, malleable, metallic uterine sound.

MANUAL VACUUM ASPIRATION (MVA)

LONG CURVED OBSTETRIC FORCEPS

SHORT CURVED OBSTETRIC FORCEPS

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