OBSTETRIC INSTRUMENTS

SIMPLE RUBBER CATHETER:

It is used to empty the bladder in cases with retention
of urine during(a) Pregnancy (Retroverted Gravid
Uterus p. 311). (b) Labor(i) when the woman fails to
pass urine by herself (ii) before and after any operative
interventions (forceps delivery p. 574, destructive
operations p. 586). (c) Post-partum (i) during
management of postpartum hemorrhage (p. 414)
(ii) retained placenta (p. 418). (d) Other uses(i) as a
tourniquet (ii) to administer O2 when nasal catheter
is not available (iii) as a mucus suckerwhen it is
attached to a mechanical or electric sucker
 Self assessment: (i) Length of
female urethra (p. 14).
(ii) Causes of retention of urine during
pregnancy,
labor and puerperium. (iii) Why a metal
catheter is
not used in obstetrics? Ans: To avoid
trauma to the
soft and vascular urethra
 Fig. 41.3 FOLEYS
CATHETER
It is used for
continuous drainage of bladder in cases with
(i) Eclampsia (p. 234). (ii) Retroverted gravid
uterus (p. 311). (iii) To give rest to the bladder
following any destructive operation and/or in
a case with suspected bladder injury (p. 587).
It is usually kept for 710 days. (iv) In the
management of atonic PPH (p. 415). (v) To
control atonic PPH. The catheter is inserted
within the uterine cavity and the catheter
balloon is inflated with normal saline.
The balloon provides a tamponade (p. 415)
to the uterine surface. The catheter drains
the blood from the uterine cavity if there is
any.
Self assessment: (i) Indications of continuous bladder drainage (p. 234, 311,
588), (ii) Causes of atonic PPH
(p. 410).
Fig. 41.4 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 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 (Cuscos speculum preferred).
(4) During D & E operation (p. 563).
 Self assessment: (i) Common
sites of traumatic PPH (p. 411)
(ii) Diagnosis of traumatic PPH
(p. 417, 423)
(iii) Indications of D + E (p. 563) (iv)
What are the local (extra placental)
causes of APH (p. 241) (v) What is
Sims position and what is Sims triad
? See authors Text Book of
Gynecology (p. 390).