This page has moved. Click here to view. Forceps DeliveryOver the last two decades, the frequency of forceps delivery has declined significantly as the cesarean delivery rate escalated. Fear of fetal injury and subsequent litigation have been at least partially responsible for this trend forceps delivery, forcep. Also responsible were inadequate definitions that grouped relatively easy deliveries, with the fetal head at or near the pelvic floor, with higher, more difficult deliveries that included rotation of more than 90 degrees. The ACOG classification categorized forceps deliveries according to station of the fetal head and degree of rotation required. The pelvis is subdivided by using centimeters from the ischial spines to the introitus (0 to +5) rather than the Forceps can be used to benefit the mother, fetus, or both. Maternal cardiac or neurologic conditions may prevent or contraindicate pushing; more often, maternal fatigue or an improperly dosed epidural may impede expulsive efforts. Nonreassuring FHR patterns may mandate delivery. Forceps delivery is indicated when a nulliparous woman has experienced arrested descent for 2 hours (3 hours with epidural anesthesia) and when a multiparous woman has had arrested descent for 1 hour (2 hours with an epidural anesthesia). Such decisions are individualized based on When a forceps delivery is contemplated, a number of prerequisites should be met:
All attempts should be viewed as a trial with a willingness to desist when difficulty is encountered either with application or with traction. Except for emergent deliveries, the patient should be thoroughly counseled regarding the The patient should be comfortably positioned in the dorsal lithotomy position with an empty bladder. Pudendal anesthesia is adequate for outlet procedures, whereas higher forceps require regional or general anesthesia. Before application, the operator confirms full dilatation and rupture of membranes. Clinical pelvimetry should rule out obvious cephalopelvic disproportion. Accurate assessment of fetal head position ensures proper symmetrical, bimalar, and Cesarean Birth Advances in anesthetic technique, blood transfusion, and antibiotics have made cesarean delivery safer, with a maternal mortality of 5-14 in 100,000 live births after adjusting for coexisting complications. Nonetheless, abdominal delivery results in a 1.5- to 7-fold increase in maternal mortality and a significant increase in morbidity, including The four most common indications for cesarean delivery in the United States are prior cesarean delivery, dystocia, fetal distress, and breech presentation. Considerable attention to reducing the present cesarean delivery rate has been focused on deliveries performed for prior cesarean delivery and dystocia, which together account for two thirds of all abdominal deliveries. Interventions to lower the cesarean delivery rate should include encouragement for women to Classification of Forceps Deliveries According to Station and Rotation
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