When are forceps the right answer?

[kaleerkalut]

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I usually get these questions right about delivery but I always find myself thinking about when should forceps be used?

I never saw a forceps case on my rotation and don't think I've ever actually seen a practice question on this either. Any help? Thanks.

 

[drk]

Certain criteria have to be present which you probably know anyways since you get it right. The woman should be in Stage 2 - fully dilated and membranes ruptured, this is obvious because your sticking something into her to grasp the side of the baby's head you need all the room you can get.

Basically you do forceps whenever there is a prolonged second stage of labor(though in practice it is not preferred at all from what I have seen, I saw 2 deliveries done using forceps and they were messy, indication was simple prolonged labor and exhausted mother, saw these outside of the USA) or if there are conditions where the mother can't exert herself due to some co-morbid condition like some cardiovascular disease.

Then there are the contraindications which are similar to scalp probe testing, HIV etc.

 

[StrangerX]

In addition to the above poster, make sure there are no problems with the power (may want to try other things to strengthen contractions, etc), passage (CPD/dystocia), or passenger (mother and fetus is stable). In the latter case, if the mom or fetus are in critical condition, you are not going to futz around with a forceps... you are gonna pop that baby out C/S style.

Also the fetus must be 2+ station. While forceps tend to be optimal if you clamp around a patient's ears, I am not sure of their utility when odd presenting parts are there.