Identify the obstetric instrument shown?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Obstetrics and Midwifery Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Explanation

The instrument shown is Kielland's forceps, identified by its unique design features.
The most prominent feature is the sliding lock on the shanks, which is specifically designed to correct for asynclitism (a tilted fetal head).
It has a minimal pelvic curve (it is nearly straight), which allows it to be safely rotated within the maternal pelvis to correct fetal malposition, such as in deep transverse arrest.
Its primary function is rotation of the fetal head, unlike other forceps which are mainly for traction.

Option A: Wrigley's forceps are much shorter and have a pronounced pelvic curve. They are not designed for rotation.
Option B: Piper's forceps have very long shanks with a specific downward-curving perineal bend to fit around the fetal body.
Option C: Das forceps are a type of long, curved obstetric forceps used for traction, similar to Simpson's forceps. They have a standard English lock and a significant pelvic curve, making them unsuitable for rotation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of obstetric instruments based on their specific morphological features and clinical applications as background academic context rather than a clinical decision trigger.
Correct identification and use of obstetric instruments are critical nursing and medical competencies in the labor room. Using the wrong instrument can lead to significant maternal and fetal trauma.
For example, attempting to rotate the fetal head with a non-rotational forceps (like Das or Wrigley's) could cause severe vaginal, cervical, or uterine lacerations for the mother and skull fractures or nerve palsies for the fetus.
A nurse assisting in an instrumental delivery must be able to anticipate the needs of the obstetrician by identifying the correct instrument for the specific clinical scenario (e.g., rotation vs. traction).

How to Approach the Question

First, carefully examine the image of the instrument provided in the question.
Identify its most distinct characteristics. In this case, note the overlapping shanks with a sliding lock, the minimal curvature of the blades, and the fenestrated (open) design of the blades.
Recall the specific features of the different types of obstetric forceps listed in the options.
Wrigley's are short outlet forceps. Piper's have a special curve for breech deliveries. Das forceps are standard traction forceps.
Kielland's forceps are uniquely characterized by their sliding lock (for asynclitism) and minimal pelvic curve (for rotation).
Match the features observed in the image to the correct description to arrive at the answer.

Concept Tested & Keywords

Concept Tested: Identification of obstetric instruments based on their specific morphological features and clinical applications.
Stem keywords: obstetric instrument, identify
Lead-in keywords: Identify

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 27-35

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