Obstetric forceps are metal instruments used to extract a baby's head during delivery. There are different types of forceps for various situations. Forceps delivery is indicated when the second stage of labor is prolonged, there is fetal or maternal distress, or during a C-section to extract the head. It involves placing the forceps blades on the baby's head and using gentle traction during contractions to deliver the baby. Potential complications include lacerations, bone injuries, nerve damage, hemorrhage, and infections. Careful clinical checks are performed to ensure proper placement and alignment of the forceps.
3. Type :
1- long curved obstetric forceps :
It consists of 2 blades each of them is 15 inches 37.5
cm long crossing each other and lock at the site of cro
ssing , each is composed of :
(1)- the blade proper ( 7.5 inches ) has 2 curves :
A- pelvic curve adapted with the maternal pelvic axis .
B- cephalic curve adapted to the fetal head .
( 2 )- the shank ( 2.5 inches ) .
(3)- lock .(
(4)- handle .
(5)- axis traction pice .
4. 2- Wrigleys forceps:
Short curved used for low and outlet forceps deliver
y .
3- killlands forceps .
4- pipers forcps :
Perineal curve allow application after coming head i
n breech delivery .
5- bartons forceps :
Indication :
Transverse arrest especially in paltypelloid pelvic wi
th flat sacrum .
5. Action of forcps :
1- traction : is the main action .
2- rotation : in deep transverse arrest persistent occ
ipto – posterior and mento – posterior .
6. Indication :
Prolonged second stage :
It is prolongation for more than one hour in primigra
vida or 30 minutes in multipara this may be due t0 :
1. inertia and poor voluntary bearing down
2. large foetus
3. rigid perineum
4. malposition
5. malpresentation
7. Maternal indication
1.maternal distress (dehydration-vital signs)
2.maternal disease (heart disease-pulmonary TB- pr
e eclampsia and eclampsia)
3. fetal indication (fetal distress-cord prolapsed)
During caesarean section :
May be used to extract the head through the uterine
incision.
9. Pre requisites for forceps application:
1. Anaesthesia: general –spinal
2.Adequate pelvic outlet
3.A septic measures
4. Bladder and bowel evacuation
5.contraction of uterine should be present
6.Dilalation of cervix should be fully
7.Engaged head
8.Membrane rupture
9.favoarable position and presentation
11. Technique of forceps Delivery
1.In occipito anterior position
clinical checks for correct forceps application
A.The sagittal suture lies in the midline of shanks
B.The operator cannot place more than a finger tip the fene
stration of the blade and the foetal head
C.The posterior fontanelle is not more than one finger –bre
adth above the plane of the shanks
12. Traction should be:
- Gentle by the force of arm only
- intermittent with uterine contraction only
- In correct direction .
- The 2 blades are unlocked contration to mini
mize the period of head compression .
13. Complications of forceps delivry:
1. Complicion of anaesthesia .
2. Laceration.
3. Bone injuries.
4. Pelvic nerve injuries.
5. Postpartum haemorrhage.
6. Puerperal infections.
7. Remot effects.