Forceps
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Forceps are a hand-held instrument used for grasping and holding objects, similar in concept to tongs, tweezers or pincers.
They are sometimes used in surgery or medical procedures, and but the most commonly thought of use for them is during childbirth. Although their use was common until the later part of the twentieth century, the use of forceps for delivery is falling out of favor in the birth community.
The word is a "binary noun", in that while it takes the plural form, it refers to a single object. Like scissors or spectacles, it does not have a strictly singular form, and may be referred to as "a pair of" forceps.
Surgical forceps
In the surgical theatre, forceps can be used to handle tissues or needles, or to grasp dressings in a sterile manner. Tissue forceps have small teeth near their tips, so that tissue can be handled without applying excessive pressure. Smooth forceps are better for grasping suture material, as when removing sutures. Dressing forceps are larger, and may appear more like "tongs" than forceps.Forceps in childbirth
Forceps can be used to assist the delivery of a baby as an alternative to the ventouse method.Technique
The cervix must be fully dilated and the bladder emptied, perhaps with the use of a catheter. The woman is placed in the lithotomy position and a mild anaesthetic is administered (unless an epidural has been given). The two sections of the forceps are individually inserted and then locked into position around the baby's head. An episiotomy is performed and then the baby is removed.Possible indicating factors
- The baby remains in the breech or other unfavourable position
- Fetal or maternal distress (though depending on the severity this may require an emergency caesarean)
- When (further) pushing is contra-indicated
- Arterial hypertension (high blood pressure)
Comparisons to other forms of assisted delivery
Positive aspects
- Can be performed even if the baby is not in the correct position, although not if the head is presenting high in the vaginal canal
- Can be used to avoid caesarean delivery
- Delivery of the infant can occur more quickly than with emergency caesarean surgery
Negative aspects
- An episiotomy is usually required which itself involves anesthesia
- The internal tissues, particularly the pelvic floor muscles, are bruised
- Women with a previous history of sexual abuse have reported feeling as though they were raped after instrumental deliveries
- An anal fissure can result, where fecal material leaks from the bowel into the vagina
- Facial bruising or temporary marks on the baby
- Nerve damage
- Skull fractures
- Cervical cord injury to the baby that results in the baby being unable to breathe unassisted
- Brain damage which can cause mild to severe mental retardation
History
Modern obstetrical forceps were invented by Peter Chamberlen around 1600 and kept a family secret for several generations. About 1730 the secret leaked out and a public design of the instrument became available.
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