FORCEPS DELIVERY

DEFINITION

FORCEPS DELIVERY IS A MEANS OF

EXTRACTING THE FETUS WITH THE AID OF
OBSTETRIC FORCEPS WHEN IT IS IN
ADVISABLE/IMPOSSIBLE FOR THE MOTHER
TO COMPLETE THE DELIVERY BY HER OWN
EFFORTS.
 INCIDENCE

IN INDIA:
CAESAREAN-43.91./.
FORCEPS -17.3 ./.
SVD -38.79./.
 CLASSIFICATION
Factors Forceps
Length Long(simpsons),Short(shortsim--
pson,wrigley)
Function Simple,Special(Axistraction,rotational),
Forceps for aftercoming head-
pipers,Extracting the head in caesarean
section-hale’s

Presence/a Non-axis traction,Axistraction(Neville-

bsence of simpson-Barnes,Milne-Murrays,haigh
axis Ferguson)
traction
Continue..

Time Prophylactic,Trial
Relation of Parallel shanks(simpson’s)
shanks
Overlapping shanks
(Kiellands,Mclane)
Station of Outlet(wrigleys,simpson)
fetal head
Low(Rotational-Kiellands)
(Non-Rotational-wrigleys,simpson)
Mid(Neville-Barnes,Haigh
Ferguson)
 PARTS OF THE FORCEPS
 1.BLADES

 2.SHANK

 3.HANDLE

 4.LOCK

 5.AXIS TRACTION FORCEPS

 FUNCTIONS

 TRACTION
 COMPRESSION

 ROTATION

 PROTECTION

 DILATATION

 IRRITATION/STIMULATION

 LEVERAGE
 INDICATIONS
 Fault in the power-Impending uterine inertia,
Prolonged II stage

 Fault in the Passage- midly contracted pelvis

 Fault in the passenger-malposition,

malpresentation, fetal distress in II stage,
cord prolapse, after coming head of breech,
low birthweight baby, postmaturity.

 Maternal indication-exhaustion/distress, placenta

previa, eclampsia,
serious heart disease, sign of impending rupture of
uterus
 CONTRAINDICATIONS
 CEPHALO PELVIC DISPROPOTION:

The disparity in the relation between the

head and the pelvis is called cephalopelvic
dispropotion.
 PRE REQUISITE
 F - full dilatation of the cervix
 O – outlet adequate/no CPD
 R - ruptured membrane
 C - contraction good
 E - engagement head is definite
 P - positive identification of presentation and
position
 S - surrounding organs (bladder, bowel) should be
emptied
 METHODS OF APPLICATION
 1.CEPHALIC APPLICATION-Here the blades
fit the babys head.
 2.PELVIC APPLICATION-Here the blades
are located idealy in relation to the pelvis
regardless of how the forceps grip the fetal
head.
 3.PERFECT APPLICATION-It is achieved
when the cephalic and pelvic application
coincide.
 TYPES OF FORCEPS
Criteria Wrigleys Simpsons Kiellands pipers

Length 27.5cm 27.5cm 40cm 44.5cm

Shank Short Short Long Long,
back
bend of
shanks

Lock French English Sliding English

 Continue….
Criteria Wrigleys Simpsons Kielland Pipers
Curve Marked No pelvic Shallow Small
cephalic, curve cephalic cephali
slight curve, ccurve,
pelvic lack of slight
curve pelvic Pelvic
curve curve
Indicatio Head- Head- Occipito After
-n introitus +1,+2 post…, coming
station Deeptra head
nsverse.
.
 TYPES OF FORCEPS
OPERATIONS
HIGH FORCEPS : Non engaged head
MIDFORCEPS:(High mid and low mid)
The biparietal diameter has not
passed the level of ischial spine.
LOW FORCEPS:The biparietal diameter
passed the level of ischial spine.
OUTLETFORCEPS:HEAD IS SEEN AT
THE INTROITUS
 EQUIPMENT
 DELIVERY SET

 APPROPRIATE FORCEPS

 WELL EQUIPPED
NEONATALRESUSCITATON AREA
 STEPS
 IDENTIFICATION OF FORCEPS

 APPLICATION OF THE BLADES

 LOCKING OF THE BLADES

 TRACTION

 REMOVAL OF THE BLADES

METHOD OF APPLICATION
METHOD OF APPLICATION
 ADVANTAGES OF FORCEPS
 Applied to after coming head of
breech
 Applied to face presentation

 Applied to dead fetus

 Ventous has a higher failuer rate

than the forceps

 Fetal soft tissue trauma is less
DELIVERY OF THE
AFTERCOMING
HEAD
 COMPLICATIONS
 MATERNAL:
Immediate-(injury,PPH,shock,sepsis)

Remote-(chronic low backache,genital prolapse,stress

incontinence)

 FETAL:
Immediate-(asphyxia,intracranial
hemorrhage,cephalohematoma,facial palsy,abrasion of the
soft tissues of the face and forehead)

Remote-(cerebral and spastic palsy)

 FAILURE OF FORCEPS
THANK YOU