notesonly.in

Prolonged second stage — vacuum applied; baby delivered safely. Operative OBGYN: episiotomy (mediolateral — 7–8 o'clock — prevents 3rd/4th degree tears: repair — layers — mucosa, muscle, skin), instrumental (forceps — outlet — traction — facial marks; vacuum — suction cup — chignon — cephalohematoma: indications — prolonged 2nd, fetal distress — prerequisites — full dilatation, engaged), C-section (LSCS — Pfannenstiel — lower segment: classical — upper — previa/accreta), hysterectomy (abdominal — large fibroids; vaginal — prolapse; laparoscopic — TLH: indications — fibroids, DUB, cancer — with BSO if malignant), D&C (diagnostic — AUB; therapeutic — incomplete abortion — now suction), sterilization (minilap — postpartum; laparoscopic — interval). Instruments assist — they don't replace judgment.