Wherever vaginal delivery is practiced there will be the need for helping out the fetus with instruments. Today, instrumental deliveries are being abandoned in favour of Cesarean section; If at all instruments are being used, it is mainly ventouse; forceps is being abandoned. Reasons for the decline in forceps use is the fear of complications. This trend can be reversed by adhering to standard protocols, proper case selection, modifying forceps and by training. Proper case selection (station- double deck), digital rotation, analgesic- pudendal block, direct application of forceps with fingers for guidance, traction following the natural curve of the birth canal will help minimize complications. One should select instruments judiciously depending on the case and the indication.
Dr. Paily discusses the safeguards of ventouse vaginal delivery. One should choose between forceps and vacuum delivery depending on the situation. Destructive operations like craniotomy may have to be performed In case of dead or non-salvageable fetus. It is essential to maintain the art of instrumental delivery.
Dr. V P Paily
Obstetrician and Gynecologist, Aluva
MBBS, MD, MRCOG, FRCOG
Special interest in Urogynecology , High risk Obstetrics, Endoscopy and Infertility.