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108 results

Page 1 of 6

Best Practice in Labour and Delivery
  • 3rd edition
  • Edited by Sir Sabaratnam Arulkumaran
  • Coming soon
  • Expected online publication date:
    November 2025
    Print publication:
    30 November 2025
  • The focus of the third edition of Best Practice in Labour and Delivery is on improvement of technical and non-technical skills, multidisciplinary team working, high quality training and audit with the goal of improving safety and quality of intrapartum care. The editor and authors from a range of international backgrounds have decades of hands-on experience in managing high risk labour wards and promoting both multidisciplinary working and high-quality training. The latest evidence from the Cochrane library and the WHO, NICE and RCOG guidelines have been incorporated into chapters spanning the stages of labour and delivery and the complications that may arise. Chapters also provide practical advice on risk management, triage and prioritisation, and non-technical skills such as leadership and decision making. The well-illustrated book is an essential read for practicing obstetricians, trainees, midwives, neonatologists, anaesthetists and obstetric physicians.

  • Chapter 14 - Instrumental Vaginal Delivery

  • from Section 3 - Intrapartum Emergencies
  • Edited by Edwin Chandraharan, Sir Sabaratnam Arulkumaran
  • Book:
    Obstetric and Intrapartum Emergencies
    Published online:
    06 May 2021
    Print publication:
    03 June 2021, pp 98-106

  • Summary

    Caesarean section rates are on the rise and this may be partly due to lack of appropriate training and experience in instrumental deliveries as well as medico-legal issues. Since caesarean section performed in the second stage of labour is associated with increased maternal morbidity, an appropriately performed instrumental vaginal delivery may help avoid the unnecessary risks.

    Instrumental vaginal deliveries can be hazardous in inexperienced hands and should be undertaken with due care and supervision. Various intrapartum measures may help reduce the need for assisted vaginal delivery such as use of partogram, upright or lateral maternal position, one-to-one support to the woman in labour, delayed pushing in women having epidural anaesthesia or judicious use of oxytocin in the second stage of labour, especially in women with epidural anaesthesia.

Page 1 of 6