Before attempting a MID-CAVITY operative vaginal delivery, which set of conditions must ALL be fulfilled?
- A Full dilatation, head visible at the introitus with pushing, and spinal anesthesia
- B Cervix at least 8 cm dilated, head at 0 station, intact membranes, and maternal consent
- C Full cervical dilatation, engaged head, ruptured membranes, known fetal position, adequate anesthesia, and an experienced operator with a clear fallback plan ✓
- D Engaged head, absent caput succedaneum, and estimated fetal weight under 3500 g
Correct answer: C. Full cervical dilatation, engaged head, ruptured membranes, known fetal position, adequate anesthesia, and an experienced operator with a clear fallback plan
Explanation
ACOG prerequisites for mid-cavity operative vaginal delivery include full dilatation, ruptured membranes, engaged head with station determined accurately, confirmed position, adequate analgesia, empty bladder if feasible, experienced operator, and readiness to abandon for cesarean. Option B fails because membranes must be ruptured and 8 cm dilatation is inadequate. Option A describes outlet delivery criteria, and absence of caput is neither required nor realistic in obstructed labour.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.