Operative Delivery




(1)
Department of Family Medicine, University of California, Riverside, Riverside, CA, USA

 






Key Points

1.

Operative delivery is defined as any procedure undertaken to facilitate delivery of an infant.

 

2.

Operative delivery methods include vacuum-assist delivery, forceps delivery, and cesarean section.

 

3.

Operative delivery should be undertaken for specific indications and those indications should be specifically noted in labor record.

 


Background


Although most deliveries will result in spontaneous vaginal delivery, under some circumstances, additional assistance is required to deliver the infant. Operative delivery is defined as any procedure undertaken to facilitate the delivery of the infant. These procedures may include vacuum-assist delivery, use of forceps, and cesarean delivery.


Forceps Delivery


The use of forceps has become increasingly uncommon in obstetrics and is now relatively uncommon. The use of forceps, however, remains a critical skill in modern obstetrics and a familiarity with the indications and general use of forceps is important for all providers of obstetrical care. The use of forceps should always be preceded by an assessment of the risks and benefits measured against the possibility of a cesarean section. Because of the skill and experience required to effectively utilize forceps and the potential complications associated with inappropriate use, forceps delivery should only be attempted for specific indications, when superior alternatives are not available or have been attempted, and by a provider with experience in both the identified indication and the appropriate use of forceps.

A variety of forceps models exist and providers should be familiar with the available types and the indications for their use. In general, all forceps consist of two pieces with curved blades and locking handles. The curve of the blades is designed to accommodate the fetal head and the maternal pelvis. The blades are not interchangeable and must be positioned correctly to assist with the two principle activities of traction and fetal rotation.

Complications associated with the use of forceps include extension of the episiotomy, laceration, uterine or bladder rupture, transient facial paralysis, and intracranial damage.

The use of forceps is classified in part on the position of the infant in the birth canal. Historically, forceps have been used with fetuses in a variety of positions and in varying degrees of descent in the birth canal. Modern use of forceps is primarily limited to two areas, outlet forceps use and low forceps use.

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Sep 23, 2016 | Posted by in OBSTETRICS | Comments Off on Operative Delivery

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