INSTRUMENTATION FOR DELIVERY ROOM

Vaginal  Used to get a better view of a woman’s cervix during pelvic

Speculum exams
 Only a portion of the speculum is inserted in the vaginal walls

1. Pediatric speculum – shortest version used to examine

vagina of infants and children
2. Huffman speculum – long, thin speculum and is narrower
than a regular speculum; used in teenaged girls who
haven’t yet been sexually active
3. Person speculum – teenage girls who’ve been sexually
active
4. Graves speculum – widest blades; use to examine adult
women
Umbilical  Non-ratcheted, finger ring scissors used for cutting the
Scissors umbilical cord after delivery

Episiotomy  Commonly used in episiotomy procedures to make the

Scissor surgical incision in the perineum and posterior vaginal wall
during labor to facilitate

Laparoscopic  Typically used to control bleeding during delivery

Sponges  Somewhat similar to gauze pads, but they can absorb more
liquid, making them a much better choice for surgical
procedures

Hemostat  Umbilical cord is most frequently clamped with the help of

this instrument before the doctor cuts it

Vacuum  A vacuum extractor uses suction to assist in childbirth

 Top of the baby’s head has a tiny suction cup attached to it
that pulls while the mother pushes

Suture  One of the most important delivery room equipment despites

of its small size
 Utilized to close wounds and restore damaged tissues caused
by laceration or episiotomy
Urinary catheter  Useful in situations where the mother may not be able to feel
the desire to urinate after receiving an epidural
 The tube is normally slowly placed into the bladder after the
epidural so the woman won’t experience any pain
 One birth is imminent, it is usually removed
Forceps  Typically used if the baby needs assistance getting through the
last portion of the birth canal or if mom has been pushing and
requires assistance
 The forceps’ tips are curled to wrap snuggly around the baby’s
head and gently bring her out
Amniotic Hook  Used in the early stages of delivery to rupture amniotic sac
 Also known as rupturing the membranes

Sponge Forceps  Commonly used in surgical procedures to hold gauze squares

that will absorb excess fluids and blood
 Ratcheted locking mechanism of these finger ring forceps
securely grip the gauze and hold it in place

Cord Tie/Cord  Cord clamp/tie is used to tie off umbilical cord when
Clamp separating the baby from placenta
 When the cord is completely dry, the clamp/tie usually falls of
on its own in about 2 to 3 weeks

Outlet Forceps  Used in mid-pelvis for rotation of the fetal head from a
persistent occipito-posterior position or for rotation when the
head has been arrested in a transverse position

Low Forceps  Leading point of the fetal skull is 22cm beyond the ischial
spines but not on the pelvic floor
 Two subdivisions:
 Rotation <45 degrees
 Rotation >45 degrees

Mid Forceps  Head is engaged (at least 0 station), but leading point of the
skull is <2cm beyond the ishial spines

Dissection  Instrument used to pinch and handle delicate tissues and

Forceps needles/ other instruments while operating
Labor and Delivery Room

Labor Room

 Known as a birthing or delivery room

 Comfortable and furnished for the process of labor and delivery of the baby to take place
 Everything is stable an hour after the delivery, the mother is shifted to postnatal care

Standard Setting of a Labor Room

 4 labor areas and labor tables

 One nursing station
 One newborn care area
 Two toilets
 Two washing areas

Labor Areas each LDR unit should have 4 Labor Areas with Following Specifications

 Each labor area should be of size 10' x 10'

 There should be a partition between two consecutive labor areas extending up to the ceiling. The partition should be
opaque till 6.5' and can have glass (optional) for the rest of the height
 Each labor area should have one labor table
 Each labor area should have one stool for a birth companion
 Each labor area should have adequate lighting and ventilation
 Each labor area should have a ceiling/wall mounted fan
 There should be two curtains, one from each side of the door, extending to the partition walls of the nursing station
area

Infection Control in Labor Room

 Keep labor room clean

 Consider every person in the room susceptible to infection
 Wash hands
 Wear sterile gloves
 Use other physical barriers
 Prevent needle/sharp injuries
 Use clean supplies and sterilized instruments
 Handle used instruments carefully
 Perform decontamination
 Ensure that the bed linen is collected and disposed properly

Setting Up Delivery Room (DR) Table

1. Perform handwashing
2. Wear cap, gown, and mask as per hospital policy
3. Place the sterile delivery set (pack) on the table delivery trolley or a flat surface above the waist
4. Maintain asepsis

Tray Issues

1. The back table should be prepared less then one (1) hour prior to procedure; preferably immediately before the
procedure begins
 2. A table cover is not recommended but if it must be covered the drape should not extend over the edge of the
table
3. The table should be prepared only inside the room in which it is intended to be used
4. No patient other than the one for which the field is prepared should enter the room with the sterile field,
whether it is covered or not
5. A new table meant for a different procedure or patient cannot be prepared in a room that is currently being
used for a procedure or patient

Assessment in Labor Room

1. Labor table with mackintosh sheet

2. Suction machine
3. Oxygen cylinder with face mask and oxygen
4. 24 hours water supply
5. Waste disposal system in place
6. Privacy in the labor room

Quality of Labor Room

 Privacy
 Availability of doctors
 Trained staff
 Behavior of staff
 Referral
 Drug availability
 Protocols
 Management of Complication
 Labor Room Register
 Partograph