Obstetrical forceps

Surgical instrument used in childbirth

Chamberlen forceps (Maldon)

Elliott forceps with "pressure regulating" screw at the end of handles – USA (1860)

Tarnier forceps with tractor handle (1877) and USA Dewey model (1900)

Obstetrical forceps used during childbirth.

French forceps, Levret-Baudelocque type (1760–1860) with perforator and hook at the end of the handles

Obstetrical forceps are a surgical instrument used in childbirth to assist in the delivery of a baby. They are designed to grasp the baby's head and guide it through the birth canal during a vaginal delivery. The use of forceps can be necessary when labor is not progressing adequately, or when the health of the mother or baby is at risk.

History

The use of obstetrical forceps dates back to the 16th century, with the Chamberlen family being credited with their invention. Over the centuries, the design and application of forceps have evolved significantly. Early forceps were rudimentary, but modern forceps are carefully designed to minimize trauma to both the mother and the baby.

Design

Obstetrical forceps consist of two blades that are curved to fit around the baby's head. The blades are joined at a pivot point, allowing them to be locked together. The handles of the forceps provide the obstetrician with the leverage needed to gently guide the baby out of the birth canal. The design of the forceps is crucial to ensure a safe delivery, and there are various types of forceps designed for different situations.

Types of Forceps

There are several types of obstetrical forceps, each suited for specific conditions during childbirth:

• Simpson Forceps: These are the most commonly used forceps, designed with a long, narrow blade to accommodate the shape of the fetal head.
• Kielland Forceps: These have a sliding mechanism that allows for rotation of the fetal head, useful in cases of malposition.
• Tucker-McLane Forceps: These are used for deliveries where the fetal head is in a transverse position.

Indications for Use

Obstetrical forceps are used in various situations, including:

• Prolonged Second Stage of Labor: When labor is not progressing, and the mother is exhausted.
• Fetal Distress: When the baby shows signs of distress and needs to be delivered quickly.
• Maternal Exhaustion: When the mother is unable to push effectively due to fatigue.

Procedure

The use of forceps requires skill and experience. The obstetrician must carefully position the blades around the baby's head, ensuring that they do not cause injury. Once the forceps are in place, gentle traction is applied to assist the delivery. The procedure is typically performed under regional anesthesia to minimize discomfort for the mother.

Risks and Complications

While forceps can be lifesaving, their use is not without risks. Potential complications include:

• For the Baby: Bruising, facial nerve injury, or skull fractures.
• For the Mother: Vaginal tears, increased risk of postpartum hemorrhage, or pelvic floor injury.

Alternatives

In some cases, a cesarean section may be considered as an alternative to forceps delivery, especially if the risks of using forceps are deemed too high.

Gallery

• 

  Obstetrical forceps, by William Smellie (1792)

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  Hodge "Eclectic" forceps – USA (1833)

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  James Young Simpson's Caesarian forceps, Hunterian Museum, Glasgow

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  Palfijn "hands" in different versions
  

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  Different parts of obstetrical forceps.

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  Wooden forceps c.1800, Hunterian Museum, Glasgow

Related pages

• Childbirth
• Cesarean section
• Vaginal delivery
• Fetal distress

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