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    Obstetric Forceps: Dr. Sourav Chowdhury Senior Resident OBG, IQCMC

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    Ritik Agarsen
    Obstetric forceps have a long history dating back to ancient India and were later developed and refined in Europe over centuries. Forceps deliveries are now classified based on the position of the fetal head and indications include maternal or fetal complications where a quick delivery is needed. Key steps in a forceps delivery include identification of landmarks, application and locking of the blades, controlled traction, and removal. Both maternal and fetal complications are possible so careful patient selection and operator skill are important.

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    Obstetric Forceps: Dr. Sourav Chowdhury Senior Resident OBG, IQCMC

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    Ritik Agarsen
    17 views22 pages
    Obstetric forceps have a long history dating back to ancient India and were later developed and refined in Europe over centuries. Forceps deliveries are now classified based on the position of the fetal head and indications include maternal or fetal complications where a quick delivery is needed. Key steps in a forceps delivery include identification of landmarks, application and locking of the blades, controlled traction, and removal. Both maternal and fetal complications are possible so careful patient selection and operator skill are important.

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    Obstetric forceps have a long history dating back to ancient India and were later developed and refined in Europe over centuries. Forceps deliveries are now classified based on the position of the fetal head and indications include maternal or fetal complications where a quick delivery is needed. Key steps in a forceps delivery include identification of landmarks, application and locking of the blades, controlled traction, and removal. Both maternal and fetal complications are possible so careful patient selection and operator skill are important.

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    17 views22 pages

    Obstetric Forceps: Dr. Sourav Chowdhury Senior Resident OBG, IQCMC

    Uploaded by

    Ritik Agarsen
    Obstetric forceps have a long history dating back to ancient India and were later developed and refined in Europe over centuries. Forceps deliveries are now classified based on the position of the fetal head and indications include maternal or fetal complications where a quick delivery is needed. Key steps in a forceps delivery include identification of landmarks, application and locking of the blades, controlled traction, and removal. Both maternal and fetal complications are possible so careful patient selection and operator skill are important.

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    Obstetric Forceps

    Dr. Sourav Chowdhury


    Senior Resident OBG, IQCMC
    History
    • ANKUSH – Vedic era
    • WILLIAM CHAMBERLAIN – Fled from France in 1569 &
    practiced forceps delivery as a family secret in
    Southampton. This was kept as a family secret for over
    100yrs and four generations.
    • Hugh (son of Hugh)-who was highly educated and respected had
    patients from best families including Duke of Buckingham
    allowed the family secret to leak.
    • Levret (1747)-introduced the pelvic curve
    • Smellie (1751)- reinforced pelvic curve & introduced English
    lock and used in aftercoming head.
    • Tarnier (1877)-introduced axis traction.
    • Barton and Kielland - introduced the two specialized forceps.
    CLASSIFICATION OF FORCEPS
    Classical

    Low or Outlet Forceps-

    Mid-Forceps

    High Forceps
    Classification of Forceps
    Newer classification as per A.C.O.G
    1981(revised in 1991):- Criteria
    Low forceps •Foetal scalp is visible without separating the vulva
    •Foetal skull has reached the pelvic floor
    •Sagital suture is in the A.P.diameter or in the Lt./Rt.
    Occiputo anterior/posterior position
    •Rotation does not exceed 45degrees
    Outlet Forceps •The leading point of the skull is 2cm or more below
    the ischeal spine but not on the pelvic floor
    •Sagital suture is in the A.P.diameter or in the Lt./Rt.
    Occiputo anterior/posterior position
    Mid-Forceps •The leading point of the skull is 2cm or less above
    the spine but head is engaged. Rotation not
    considered
    High Forceps Excluded
    Parts of Forceps

    Screw Handle Lock Shank Blades


    Functions
    Traction
    • Traction

    Rotation

    Protective cage

    Controlled Delivery

    As vectis

    Compression Effect
    Indications of Forceps
    • Cut-short 2nd stage eclampsia preeclampsia
    • Maternal exhaustion

    Maternal • Conditions where expulsive efforts are


    Prohibited
    • Prolonged second stage

    • Non-reassuring FHS
    • After coming of head in Breech
    Fetal •
    •
    Suspicion of fetal compromise
    Low Birth wt. &
    • Post-maturity
    Contraindications

    Incompletely dilated cervix

    Floating Head

    Obstructed labour due to contracted pelvis

    Malpresentation like brow, mentoanterior, face


    Pre-requisites for
    Forceps delivery

    Maternal Fetal Others


    •Cervix fully dilated •Fetal head engaged •Presence of
    •Membrane ruptured •Fetal head station exactly neonatologist
    •Pelvis adequate known •Aseptic technique
    •Bladder empty •Informed consent
    •Adequate maternal •Experienced obstetrician
    Anaesthesia & Analgesia •Episiotomy
    Types of Application of Forceps

    Cephalic-

    Pelvic-
    Technique
    (of low & outlet forceps application )
    Step I-Identification & Application

    Step II-Locking of Blades & Fixation

    Step III-Traction

    Step IV- Removal of Blades


    Application of forceps
    Forceps for After coming of Head

    Pipers Forceps

    Forceps to be applied when the occiput lies


    against the back of the symphysis

    Blades to be applied from below after raising the legs.

    Traction to be maintained in an arc,


    which follows the axis of the birth canal.
    Maternal Complications
    Injury

    Nerve Injury

    Post-partum Haemorrrhage

    Anaesthesia Complications

    Puerperal Sepsis

    Maternal Morbidity
    Fetal Complications
    Asphyxia

    Facial bruising, Intracranial Haemorrhage

    Cephalohaematome

    Facial Palsy

    Skull # & Cervical Spine Injury


    Prophylactic Forceps
    This refers to delivery by forceps application to
    shorten second stage of labour when maternal and
    fetal complications are anticipated.

    Eclampsia

    Heart disease

    Post C/S

    LBW

    Under Epidural Anaesthesia


    Trial Forceps

    IT’S A TENATIVE ATTEMPT OF FORCEPS


    DELIVERY IN A CASE OF SUSPECTED
    MIDPELVIC CONTRACTION WITH A PREAMBLE
    DECLARATION OF ABANDONING IT IN FAVOUR
    OF CAESAREAN SECTION IF MODERATE
    TRACTION FAILS TO OVERCOME RESISTANCE.
    Failed Forceps
    When deliberate attempt in a vaginal delivery
    with forceps has failed to expedite the process, it is
    called failed forceps.

    Common causes:- Management :-


    •Incompletely dilated cervix •To assess
    •Unrotated occipito-posterior •IV fluid RL and arrange BT
    •CPD •Administer antibiotic
    •Unrecognised malrotation •Exclude Uterine rupture
    •Big baby •Abandon & Em-LSCS
    •Maternal BMI >30 •Laparotomy in Rupture
    U can GO back to……….

    Zzzzzzzz

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