BEDAH OBSTETRI

Syamel Muhammad
 Curriculum Vitae
Nama : Dr. Syamel Muhammad, SpOG K.Onk

Nip : 198320112008121001
E-Mail : Syamelmuhammad@yahoo.com
Kantor : Bagian/SMF Obstetri dan Ginekologi Fakultas Kedokteran Universitas Andalas
Status : Menikah
Riwayat Pendidikan : Pendidikan Dokter Fakultas Kedokteran Univ. Andalas (2001-2007)
PPDS Obstetri dan Ginekologi Fak.Kedokteran Univ. Andalas (2008- 2013)
PPDS 2 Onkologi Ginekologi Fak. Kedokteran Univ. Padjajaran
Riwayat Pekerjaan : Staf Pengajar Fak. Kedokteran Univ. Andalas (2008-sekarang)
Pelatihan :
1. Advanced Ultrasound in Obstetri and Gynecology
2. Tutor Training
3. TOT Evidence Based Medicine
4. Workshop How to set Up Clinical Trial
5.Pembicara pada: Applied Surgical Anatomy in Obstetrics and Gynecology Surgery Workshop
6.The 3rd Basic Laparoscopic Surgical Skill Training Program in Gynecologic Oncology
7.Laparoscopy training in 7th INASGO Bineal meeting
8.Gynecology Cancer Screening and Management
9.XVIII World Congress on Gestational Trophoblastic Diseases
Makalah :
• Simple Hysterectomy in Cervical Cancer (PIT POGI 19)
• The Deference of Uterine Artery Resistence Index (RI) and Pulsatility Index (PI) between Early Onset Severe Preeclampsia and Late Onset
Severe Preeclampsia. (Tesis)
Pengabdian Masyarakat :
1. Tenaga Kesehatan pada World Cancer Day event di Bandung
2. Tenaga kesehatan pada Bakti Sosial Pemeriksaan Kesehatan dan pengobatan gratis di Kota Bandung
3. Pembicara pada Pelatihan deteksi dini kanker leher rahim dan kanker payudara di kabupaten Indramayu Jawabarat
4. Pembicara pada Pelatihan deteksi dini kanker leher rahim dan kanker payudara di kabupaten Pangandaran Jawabarat
5. Pelatihan Iva test bagu Bidan oleh Yayasan Kanker Indonesia Cabang Jawabarat
6. Pembicara pada Surgical Anatomy workshop Hasan Sadikin Hospital Bandung
 out line
• introduction

• Forceps Extraction

• Vacuum Extraction

• Curettage

• Ectopic pregnancy

• Caecarean Section
 Introduction
• Procedure to manage obstetrics condition

• Vaginal procedur

• Forceps or Vacuum extraction (Assisted vaginal delivery)

• Curettage

• Perineoraphy

• Abdominal procedure

• C-Section

• Laparotomy for ectopic pregnancy

• Hysterectomy
Assisted Vaginal Delivery
• Vacuum extractors have replaced forceps for many situations in
which assistance is required to achieve vaginal delivery.

• Compared with metal-cup vacuum extractors, soft-cup devices are

easier to use and cause fewer neonatal scalp injuries; however, they
detach more frequently.

• Vacuum extractors can cause neonatal injury. These devices should

be employed when indicated, usually for a nonreassuring fetal heart
tracing or failure to progress in the second stage of labor.

• Complications may be minimized if the physician recognizes

contraindications to the use of vacuum extraction. Complete
documentation is essential
Types of Vacuum Extractors
• The metal-cup vacuum extractor is a mushroom-shaped metal cup varying from
40 to 60 mm in diameter.

• A centrally attached chain connects the cup to a detachable handle that is

used to apply traction.

• A mechanical or electrical suction device is attached to the metal cup via a

peripherally located vacuum port

• SOFT CUPS

• Compared with metal-cup devices, soft-cup vacuum extractors cause fewer

neonatal scalp injuries. However, these instruments have a higher failure rate.

• Soft-cup instruments can be used with a manual vacuum pump or an

electrical suction device. Some have a built-in vacuum-release valve that
allows pressure to be rapidly attained and accurately controlled.
 Comparative Advantages of
Vacuum Extractors and Forceps
• Vacuum extractors

• Easier to learn

• Quicker delivery

• Less maternal genital trauma

• Less maternal discomfort

• Fewer neonatal craniofacial injuries

• Less anesthesia required

• Forceps

• Fewer neonatal injuries, including cephalohematoma, retinal hemorrhage and transient lateral
rectus palsy

• Higher rate of successful vaginal delivery

TABLE 2
Indications for Vacuum-Assisted Delivery

Maternal indications

Need to avoid voluntary maternal expulsive efforts (e.g., the mother has cardiac or cerebrovascular disease)

Inadequate maternal expulsive efforts

Maternal exhaustion or lack of cooperation

Fetal indications

Nonreassuring fetal heart tracing

Prolonged second stage of labor

Failure to progress in second stage of labor

Information from references: 1, 9, 10 and 12.

 Relative Contraindications
for Vacuum Extraction
• Fetal prematurity (< 34 weeks of gestation)

• Fetal scalp trauma

• Unengaged head

• Incomplete cervical dilatation

• Active bleeding or suspected fetal coagulation defects

• Suspected macrosomia

• Nonvertex presentation or other malpresentation

• Cephalopelvic disproportion

• Delivery requiring rotation or excessive traction

• Inadequate anesthesia
Curettage
Perineoraphy
Cecarean Section
Laparotomy/Laparoscopic
for Ectopic Pregnancy
Hysterectomy
Terimakasih