Destructive Operations (Embryotomy)

Craniotomy: This is perforation of the skill to allow drainage ofthe cerebral spinal fluids (CSF) and brain tissue causing collapse of the skull bone and allow vaginal delivery. It is performed when the fetus is dead and labour is obstructed by hydrocephaly, cephalopelvic disproportion and malpresentations. In head presenting a pointed instrument is used such as a wide-bore tracer and cannula, cranioclast and cophalotribe Simpson’s perforator or oldhorn’s perforator. The skull sutures are perforated and the head collapsed. This is followed by extraction, crochet obstetric forceps may be applied if the head is still too large to pass. Decapitation: This is severing of the head from the trunk.

Indication :

· Impacted shoulder presentation

· Locked twins.

· Double headed monsters.

The instrument used is blond- Heidler thinble and wire saw or sharp and serrated decapitation hooks (Ramabothams), embroyotomy scissors.

Cleridotomy: This is cutting of one or bath clavicles to reduce the width of the shoulder girdle in big babies, postmature, anencephalic, monster, shoulder dystocia, contracted pelvis with a dead baby. Emboyotomy scissors are used. Heavy, long straight scissors can be used as well.

Evisceration: This is incision of the abdomen to remove theabdominal or thoracic content incases of tumour or excessive ascitis obstructing labour. Occasionally it is done in impacted shoulder when the neck can not be reached. The abdomen or chest is opened using a perforator and the content removed manually.The pre and post operative cares care as for any vaginal obstetric operations. Most of these have replaced with caesarean section because of injury to the mother .