Forceps are surgical instruments that resemble a pair of tongs, that can be used in surgery for grabbing, maneuvering, or removing various things within or from the body.
Indications
Maternal factors:
Maternal exhaustion
Prolonged 2nd stage
Maternal illness, e.g. heart disease, HTN, glaucoma, aneurysm, or other things which make pushing difficult or dangerous
Hemorrhage
Analgesic drug-related inhibition of maternal effort, especially with epidural/spinal
Fetal factors:
Non-reassuring CTG
Method
Anglo-American types, including:
Neville Barnes forceps
Simpson forceps
Elliot forceps
Keilland forceps
Wrigley's forceps
Piper's forceps
Classification
Outlet forceps, where forceps are applied when the fetal head has reached the perineal floor and its scalp is visible between contractions. It is performed only when the fetal head is in a straight forward or backward vertex position or in slight rotation (<45 degrees to the R o L) from 1 of these positions
Low forceps, when the baby's head is at +2 station or lower. There is no restriction on rotation for this type of delivery
Mid forceps, when the baby's head is above +2 station. There must be head engagement before it can be carried out
High forceps, is NOT performed in modern obstetrics practice
Advantages
Avoidance of C section
Reduction of delivery time
General applicability with cephalic presentation
Complications
Fetal:
Cuts and bruises
Deformation
Facial nerve injury, usually temporary, occasionally
Clavicle fracture, rarely
Skull fractures
Intracranial hemorrhage
Cervical cord injury
Strabismus, due to improper twisting of the neck, causing damage to CN6
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