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A randomised prospective trial of the obstetric forceps versus vacuum extraction using defined criteria.

The objective of this study was to determine the safety of obstetrics forceps when used under strictly defined criteria compared to vacuum extraction for delivery in the second stage of labour. A randomised prospective trial was performed on 442 women undergoing instrumental delivery in the second stage. Two hundred and four women were in the forceps group and 238 in the vacuum group. When using forceps traction efforts to deliver the baby were kept to less than three and the head was always delivered in the occipito-anterior position. In the two groups there were no significant difference in the incidence of third-degree perineal tears, post-partum haemorrhage or ruptured uterus. Cervical tears were slightly higher in the forceps group. Babies delivered by vacuum extraction showed a higher incidence of cephalhaematomas. There was no significant difference in babies needing resuscitation at birth, admission to neonatal intensive care unit, stillbirth or neonatal death rates. The failure rate was significantly higher in the vacuum group. The time taken to complete the procedure was significantly less in the forceps group. Forceps deliveries when performed under defined criteria are as safe as vacuum deliveries to the mother with a lesser failure rate and a lower incidence of cephalhaematomas in the neonate compared with vacuum deliveries.

Adult↗

["An appropriate forceps"--150-year anniversary of Simpson's forceps].

Despite the increasing use of caesarean section and vacuum extraction, obstetric forceps is still in frequent use in obstetric wards. There has, in fact, been an increase due to more active management of births. More than 600 obstetric forceps have been described in detail, but only three of them are in use in Norway today: Simpson's and Kielland's forceps for vertex presentation and Piper's forceps for aftercoming head in breech presentation. This year it is 150 years since James Young Simpson (1811-70) of Edinburgh presented his forceps for the first time. Simpson's forceps has been the most widely used forceps in Norway over the last 120 years. This article describes James Young Simpson, his long forceps, and its use in Norwegian obstetrics.

Female↗