PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “OBSTETRICAL FORCEPS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed2001

Teaching the Laufe-Piper forceps technique at cesarean delivery.

OBJECTIVE: To present a method of teaching forceps technique during cesarean delivery of breech-presenting infants using Laufe-Piper forceps and to evaluate its usefulness. STUDY DESIGN: For several years, residents at the University of Texas Medical Branch, Galveston, have learned and practiced Piper forceps technique during cesarean delivery. To assess their experience with this method, we mailed questionnaires to third- and fourth-year residents and recent graduates of the Galveston program. The same surveys were mailed to a control group of residents and recent graduates of two other programs where this teaching exercise is not practiced routinely. RESULTS: Responses were received from 32 (74%) study subjects and 63 (71%) controls. Demographic characteristics and experience with vaginal breech delivery were similar between the two groups. Respondents from the Galveston program noted greater annual use of forceps for vaginal delivery of cephalic-presenting infants (P = .012). They also rated themselves as more comfortable (P = .023) and more skilled (P = .006) with Piper forceps than controls. Of 53 respondents who had had previous experience with this teaching method, 47 noted that it provided a great or moderate educational benefit, and 36 strongly or moderately believed it gave them more confidence in using Piper forceps during vaginal breech delivery. Using multiple regression analysis, sex, overall level of experience, Piper forceps experience during vaginal delivery and overall forceps use were stronger determinants of self-rated comfort and skill than was experience with Laufe-Piper forceps during cesarean. CONCLUSION: Laufe-Piper forceps can be used for cesarean delivery of breech-presenting infants. This practice promotes confidence and skill for their use at vaginal delivery.

Breech Presentation↗
PubMed1986

Forceps delivery.

Explore the source record for details and available documents.

Extraction, Obstetrical↗
PubMed1993

Survey of forceps delivery in North America in 1990.

OBJECTIVE: To determine whether opinions and practice patterns have markedly changed over the past decade and whether clinicians are cognizant of the new ACOG definitions for forceps deliveries. METHODS: Two hundred ninety-five United States and Canadian residency programs were surveyed via a questionnaire; 203 (69%) responded. Statistical analysis was performed using the chi 2 test, Yates correction factor, and the extended Mantel-Haenszel test. RESULTS: All but two program directors (99%) were familiar with the new definitions, which were being used by 162 (80%) of the programs. All institutions used outlet and low forceps, although 14% no longer performed midforceps deliveries. Attending faculty were the primary instructors in 67% of United States and 100% of Canadian programs. Simpson forceps were the most commonly used for outlet (46%) and low (43%) forceps deliveries. Kielland (27%) and Simpson (24%) instruments were most commonly used for midforceps deliveries. CONCLUSION: Although the rate of midforceps use decreased, operative vaginal delivery was still commonly taught in residency programs in North America in 1990.

Canada↗
PubMedDate not supplied

Episiotomy in low-risk vaginal deliveries.

PURPOSE: The object of this study was to determine factors leading to episiotomy in low-risk vaginal deliveries, including a comparison of family physicians with obstetricians. The research was also to assess the incidence of episiotomy in a large community hospital and compare it with a national rate of 40%. METHODS: A retrospective cohort design was used with computerized records from one hospital. Demographic and clinical information was extracted from the database, including parity, age, physician type, anesthesia, induction, fetal complications, and other factors. Only low-risk vaginal deliveries (n = 3120) from the year 2003 were included. RESULTS: There was an overall episiotomy incidence of 48%; obstetricians performed episiotomy in 54% of their low-risk patients and family physicians in 33% of similar women (P < .001). Adjusted for multiple factors, the odds ratio for obstetricians performing episiotomy was 2.38 [1.98 to 2.87 (95% confidence interval (CI))]. Instrument-assisted delivery was the strongest predictor for episiotomy, with an adjusted odds ratio for forceps of 5.08 [3.75 to 6.88 CI], and vacuum 2.86 [1.78 to 4.58 CI]. CONCLUSION: Episiotomy in this hospital is being performed in almost half of all vaginal births. Obstetricians are more than twice as likely to perform episiotomy as family physicians in similar patients. Instrument-assisted delivery is a strong risk factor for episiotomy.

Adult↗
PubMed2005

The disappearing art of instrumental delivery: time to reverse the trend.

PURPOSE: This paper focuses attention on declining rates of instrumental (vacuum or forceps) delivery. The decline often means that women must travel further to deliver in hospitals with capacity for cesarean delivery. BACKGROUND: The paper illustrates recent trends in the use of vacuum extraction and forceps in low- and high-income countries. It describes some of the obstacles to the use of instrumental delivery and why the techniques, especially vacuum extraction, should be reintroduced. Over the past two decades, many countries have observed a decline in instrumental delivery rates while cesarean rates have increased. Objections to instrumental delivery are largely due to the potential harm it causes newborns. Some medical schools no longer train their professionals to perform instrumental delivery. Elsewhere, only specialists are permitted to perform the procedures. METHODS AND RESULTS: As this is a policy paper rather than a research report, the methods and results sections are not applicable. CONCLUSIONS: Vacuum extraction can be taught to midlevel practitioners (midwives, nurse practitioners and general physicians), thereby increasing access to emergency obstetric care especially at the periphery. This allows women to give birth closer to home in midlevel facilities when hospitals are not easily accessible or are overcrowded. Where instrumental and cesarean delivery are both available, instrumental delivery could potentially reduce the risks associated with cesarean delivery and reduce the costs of obstetric care.

Cesarean Section↗