Overview

Forceps Delivery is an instrumental delivery procedure used to assist vaginal delivery when maternal or fetal complications arise. It requires careful technique and proper indications.

Forceps delivery is crucial for expediting delivery in cases of fetal distress, maternal exhaustion, or prolonged second stage of labor. It can prevent cesarean section in appropriate cases.

Learn more in our comprehensive RxDx OBG Course

Indications

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Fetal Distress

Non-reassuring fetal heart rate

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Maternal Exhaustion

Inability to push effectively

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Prolonged Second Stage

Failure to progress

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Maternal Medical Conditions

Cardiac, respiratory disease

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Fetal Malposition

Occiput posterior position

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Cephalopelvic disproportion

Relative Contraindications

✗ Unengaged fetal head
✗ Incomplete cervical dilation

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, adequate analgesia, proper positioning, equipment setup, and team briefing.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, position patient.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor positioning

💡 Pro Tip:

Ensure adequate analgesia.

Step 2: Assessment

Assess fetal position, station, and maternal pelvis.

⚠️ Common Mistakes to Avoid:

  • Wrong assessment
  • Missed contraindications

💡 Pro Tip:

Confirm fetal position carefully.

Step 3: Forceps Application

Apply forceps blades correctly.

⚠️ Common Mistakes to Avoid:

  • Wrong application
  • Incomplete application

💡 Pro Tip:

Apply blades systematically.

Step 4: Traction

Apply gentle traction in correct direction.

⚠️ Common Mistakes to Avoid:

  • Excessive force
  • Wrong direction

💡 Pro Tip:

Use gentle, steady traction.

Step 5: Delivery

Complete delivery of baby.

⚠️ Common Mistakes to Avoid:

  • Rushed delivery
  • Incomplete delivery

💡 Pro Tip:

Complete delivery carefully.

Step 6: Episiotomy Repair

Repair episiotomy if performed.

⚠️ Common Mistakes to Avoid:

  • Incomplete repair
  • Poor approximation

💡 Pro Tip:

Repair in anatomical layers.

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Post-procedure Care

Post-procedure care involves monitoring for complications, perineal care, and patient education.

Complications & Management

Complication Incidence Signs Management Prevention
Perineal trauma 15-30% Laceration, bleeding Repair, hemostasis Episiotomy when needed
Fetal trauma 5-10% Facial bruising, nerve injury Neonatal assessment Gentle technique
Maternal trauma 10-20% Vaginal laceration, bleeding Repair, hemostasis Careful technique
Failed forceps 3-8% Inability to deliver Cesarean section Proper assessment

Clinical Pearls

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Confirm fetal position before application.

🎯

Apply forceps systematically.

⚡

Use gentle, steady traction.

🔍

Ensure adequate analgesia.

📊

Monitor fetal heart rate throughout.

🎨

Repair any trauma properly.

⚠️

Be prepared for cesarean if needed.