[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.00,0:00:03.23,Default,,0000,0000,0000,,The next step is to deliver the fetus
Dialogue: 0,0:00:03.31,0:00:07.80,Default,,0000,0000,0000,,where we would insert our hand below the head
Dialogue: 0,0:00:07.80,0:00:10.48,Default,,0000,0000,0000,,and we remove the retractor
Dialogue: 0,0:00:10.51,0:00:13.80,Default,,0000,0000,0000,,and as soon as the head is delivered
Dialogue: 0,0:00:13.85,0:00:17.01,Default,,0000,0000,0000,,before the delivery of the shoulder
Dialogue: 0,0:00:17.01,0:00:20.57,Default,,0000,0000,0000,,we would be first suctioning the mouth
Dialogue: 0,0:00:20.70,0:00:22.97,Default,,0000,0000,0000,,followed by the nostrils
Dialogue: 0,0:00:24.40,0:00:24.40,Default,,0000,0000,0000,,suctioning the mouth first would decrease the risk of aspiration
Dialogue: 0,0:00:24.40,0:00:24.40,Default,,0000,0000,0000,,and then we would deliver the whole baby
Dialogue: 0,0:00:24.40,0:00:26.64,Default,,0000,0000,0000,,and continue with the suction
Dialogue: 0,0:00:26.64,0:00:31.18,Default,,0000,0000,0000,,while we are clamping the cord
Dialogue: 0,0:00:31.18,0:00:32.91,Default,,0000,0000,0000,,the chord would be clamped
Dialogue: 0,0:00:32.91,0:00:35.69,Default,,0000,0000,0000,,at two points
Dialogue: 0,0:00:35.69,0:00:44.86,Default,,0000,0000,0000,,and would be cut by the assistant and the baby would be
Dialogue: 0,0:00:44.86,0:00:47.12,Default,,0000,0000,0000,,taken to continuing resusitation
Dialogue: 0,0:00:47.12,0:00:49.70,Default,,0000,0000,0000,,the next step now is to deliver the placenta
Dialogue: 0,0:00:49.70,0:00:56.46,Default,,0000,0000,0000,,theh placenta can be delivered by manual removal or controlled contraction
Dialogue: 0,0:00:56.46,0:01:02.30,Default,,0000,0000,0000,,the risk of bleeding and the risk of infection is found to be higher in removing it by manually
Dialogue: 0,0:01:02.30,0:01:04.94,Default,,0000,0000,0000,,so the preferable way is to remove it by controlled contraction, as you can see here
Dialogue: 0,0:01:04.94,0:01:13.73,Default,,0000,0000,0000,,also when the baby is being deivered
Dialogue: 0,0:01:13.73,0:01:18.40,Default,,0000,0000,0000,,we should give oxytocin to the mother
Dialogue: 0,0:01:18.40,0:01:26.58,Default,,0000,0000,0000,,and also during the delivery of the fetus also to give prophylactic antibiotics
Dialogue: 0,0:01:26.58,0:01:33.40,Default,,0000,0000,0000,,once we deliver the placenta
Dialogue: 0,0:01:33.40,0:01:39.34,Default,,0000,0000,0000,,it is always good to mop the inside of the uterine cavity
Dialogue: 0,0:01:39.34,0:01:45.38,Default,,0000,0000,0000,,to be sure we have not left any fragments of placenta or membranes
Dialogue: 0,0:01:45.38,0:01:57.11,Default,,0000,0000,0000,,and then we'll exteriorize the uterus to, both for easy visualization of the repair and also to see any bleeding,
Dialogue: 0,0:01:57.11,0:02:03.74,Default,,0000,0000,0000,,we should insert the X retractor at this point and we should look for any bleeders
Dialogue: 0,0:02:03.74,0:02:11.91,Default,,0000,0000,0000,,and this is where we are going to use a green armitage that you can see here holding, the surgeon holding
Dialogue: 0,0:02:11.91,0:02:17.13,Default,,0000,0000,0000,,and the green armitage is specific used for cesarean section because it is a clamp that can bring hemostasis without crushing the uterine wall
Dialogue: 0,0:02:17.13,0:02:27.39,Default,,0000,0000,0000,,all the bleeders would be clamped by the green armitage before we start
Dialogue: 0,0:02:27.39,0:02:29.98,Default,,0000,0000,0000,,the closure, closing the uterine incision
Dialogue: 0,0:02:29.98,0:02:33.14,Default,,0000,0000,0000,,This is the stage where we are going to dilate the cervix
Dialogue: 0,0:02:33.14,0:02:40.15,Default,,0000,0000,0000,,so we have good drainage
Dialogue: 0,0:02:40.15,0:02:44.15,Default,,0000,0000,0000,,using either fingers or sponge x