1. FORCEPS

2. DEFINITION
Obstetrics forceps is a pair of instruments specially designed to assist extraction of the fetal head and thereby accomplishing delivery of the fetus.

3. DESIGN OF FORCEPS
Blades
Shank
Lock
handle
Axis traction device

7. TYPES HIGH FORCEPS OPERATION
BP diameter has not yet passed the plane of pelvic inlet
MID FORCEPS OPERATION
BP diameter has passed the plane of inlet but has not passed the level of ischial spine
High mid
BP diameter above the level of ischial spine
Low mid
BP diameter at the level of ischial spine
LOW FORCEPS OPERATION
BP diameter has passed the level of ischial spine
OUTLET FORCEPS
Head lying on the perineum and visible at the introitus in between contraction

8. FUNCTION
Traction: - Pull required in a primigravida is 18 kgs & in a multipara it is 13 kgs.
Compression effect: -However it has some pressure effect on the well-ossified base of the skull.
Rotation of head
Protective cage
As a vectis: - By applying one blade to deliver the head in caesarean section.

9. INDICATIONS DELAY IN THE SECOND STAGE FETAL INDICATION Fetal distress
Cord prolapse
After coming head of breech
Low birth weight baby
Postmaturity

10. Contd…. MATERNAL INDICATION Maternal distress Pre – eclampsia
Post cesarean pregnancy
Heart disease

11. Conditions to be fulfilled
The head must be engaged
The fetus must present as a vertex or by the face with the chin anterior.
The cervix must be completely dilated and effaced
Membrane must be rupture
There should not be undue obstruction
Baby should be living
Uterus should be preferably contracting and relaxing
The bladder must be emptied

12. TECHNIQUES: 1.ANESTHESIA – 1% LIGNOCAINE HYDROCHLORIDE

13. Contd… STEPS Identification of the blades and their application
2. CATHETERISATION
3. EPISIOTOMY
STEPS
Identification of the blades and their application
Locking of the blades
Traction
Removal of the blades

20. MATERNAL COMPLICATIONS
IMMEDIATE
Injury
PPH
Shock
Sepsis
Anaesthetic hazards
REMOTE
Chronic low backache
Genital prolapse
Stress incontinence

21. FETAL COMPLICATIONS IMMEDIATE Asphyxia Intracranial haemorrhage
Cephalhaematoma
Facial palsy
Abrasions on the soft tissues of the face
REMOTE
Cerebral and spastic palsy due to residual cerebral injury

22. FETAL COMPLICATIONS