Instrumental Delivery

John Patrick O'Grady; Martin L. Gimovsky; Lucy A. Bayer-Zwirello; Kevin Giordano

doi:10.1017/CBO9780511580987.019

Chapter 17 - Instrumental Delivery

from Part III - SURGICAL PROCEDURES

Published online by Cambridge University Press: 07 May 2010

John Patrick O'Grady ,

Martin L. Gimovsky ,

Lucy A. Bayer-Zwirello and

Kevin Giordano

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John Patrick O'Grady: Affiliation:
Tufts University, Massachusetts

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Summary

This chapter discusses instrument design, technique of application, and the risks and benefits of assisted delivery. The principal controversies concerning instrumental delivery by both forceps and the vacuum extractor are reviewed, and recommendations are made about the use of these instruments. The focus of this presentation remains the desirability and safety of instrumental delivery and a critical analysis of what constitute the best modern practice. Delivery instruments are conveniently classified into eight types: five of forceps, two of vacuum extractors, and one for miscellaneous instruments. The most important contraindications to vaginal delivery operations are operator inexperience and the inability to achieve a proper application. Educating clinicians in the appropriate use of force in instrumental deliveries is a difficult task. Instrument application involves forceps operation, and vacuum extraction. Maternal perineal lacerations are common complications of all operative vaginal deliveries; most are associated with episiotomy.

Keywords

cesarean delivery episiotomy forceps operation vacuum extraction instrumental delivery maternal perineal lacerations

Type: Chapter
Information: Operative Obstetrics , pp. 455 - 508

DOI: https://doi.org/10.1017/CBO9780511580987.019 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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Chapter 17 - Instrumental Delivery

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