OBSTETRIC INSTRUMENTS

1. 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
2.CUSCO’S BIVALVE SELF RETAINING VAGINAL
SPECULUM:
Uses:
(i) To visualize the cervix and vaginal fornices for any local cause (polyp, ectopy) 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

3.MULTIPLE TOOTHED VULSELLUM:

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.
4.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 ani externus 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

5.LONG STRAIGHT HEMOSTATIC FORCEPS:

Use: This is not commonly used in obstetrics. It can be used to clamp the pedicle while
removing the uterus as in rupture uterus. The umbilical cord may be clamped as an alternative
to Kocher’s.
6.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

7.LONG STRAIGHT SCISSORS

USES: It is commonly used to cut the
(i) umbilical cord
(ii) to make episiotomy
(iii) to cut suture materials as in cesarean section.
8.UTERINE SOUND:
It is an olive pointed, graduated, malleable, metallic uterine sound.
USES:
(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.

9.CERVICAL DILATORS: HAWKIN-AMBLER AND DAS OR

HEGAR’S DILATORS
HAWKIN-AMBLER: It has got 16 sizes, the smallest one being 3/6 and the largest one being
18/21. The number is arbitrary in the scale of HawkinAmbler. The smaller one denotes
measurement at the tip and the larger one measures the maximum diameter at the base in mm.
DAS OR HEGAR’S DILATORS is a double ended one. The minimum size is 1/2 and the
maximum size is 11/12. The number represents the diameter in mm. Both the sides are used
with the lower number first.
Use: It is used in dilatation of the cervical canal prior to evacuation operation. Degree of
dilatation required: (i) Incomplete abortion—sufficient to introduce the index finger (usually
16/19). (ii) In suction evacuation—one size smaller than the size of the suction cannula. (iii)
In MTP by D + E—sufficient dilatation to introduce ovum forceps (usually 9/12).
10. 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.
11.DOYEN’S RETRACTOR:
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