Forceps Delivery

Forceps Delivery

This is a means of extracting the fetus with aid of obstetric forceps when it is impossible for the mother to complete the delivery by her effort.

It can also be used to aid the delivery of the after-coming head in breech delivery and to withdraw the head out of the pelvis during caesarean section.

Classification

i.                  High forceps

ii.                  Mid-cavity

iii.                  Low-cavity

The last one is one commonly used while the former two have been replaced by caesarean section due to its traumatic complications.

Types of obstetric forceps

i.                  Ungley’s forceps: short handle used for low forceps deliveries, after – coming head and at caesarean se ction.

ii.                  Simpson’s forceps; standard, low cavity forceps.

iii.                  Neville – Bornes: anderson’s forceps. Haigfergusons , Miler Murray. These are all for high and mid-cavity deliveries.

iv.                  Kielland’s forceps: for rotation of the head from OP or OL. It has no cephalic curve it is for rotation.

Indications for forcep delivery

i.                  Delay in 2^nd stage of labour – e.g. Poor contraction or maternal effort, mal-rotation rigid perineum, use of epidural anaesthesia.

ii.                  Fetal distress in 2^nd stage

iii.                  Mal-position – OPL & OPP.

iv.                  Maternal distress or exhaustion – when pushing is undersirable: Hypertension, Cardiac disease, emotional over-stressed.

v.                  Breech presentation – After coming head.

vi.                  Preterm babies – To protect the delicate fetal head .

Favorable conditions for forceps delivery

i.                  Full dilatation of the cervix.

ii.                  Membranes must be ruptured.

iii.                  Presentation & Position must be accertained

iv.                  Suitable presenting part – vertex, (b) Face, after- coming head in breech. – No CPD.

v.                  Head must be engaged and bladder empty.

vi.                  Suitable anesthesia

Preparation

i.                  Patient & husband must be informed of the progress of labour.

ii.                  Appropriate analgesia must be offered.

iii.                  Place in lithotomy position.

iv.                  Minimise discomfort and embarrassment to the woman.

v.                  Preparation for resuscitation must be available.

A midwife must always be with the woman for full attention and support .

Fetal heart rate must be monitored throughout