1. Position of Accoucheur during Forceps Delivery
While Obstetric forceps are being applied, what should be the position of the accoucheur (a person who assists during childbirth)?
Correct Answer: a) Standing.
Some books mention sitting position and some does not mention anything.
In a research published in Obstet Gynecol (2005), forces generated from the sitting position in particular can often exceed the preferred range (30-45lb). The mean maximum traction produced by men in the standing and sitting positions was 69.5 and 85.8 pounds, respectively. For women, the mean maximum force generated was 45.5 pounds in the standing position and 61.3 pounds in the sitting position.
I never conducted obstetric forceps in sitting position, as I was trained like that.
Those who are trained in sitting position, they have adapted themselves to generate adequete force. So there is no need to change their current practice of sitting position.
2. When to abandon obstetric forceps delivery
a) No evidence of descent with traction with trial forceps
b) Delivery is not eminent following three contractions
c) Delivery is not eminent following five contractions
d) Failed attempts for five minutes
e) Failed attempts for seven minutes
Correct Answer: a and b. One needs to abandon forceps if there is no eminent delivery in3 successive contraction. “Trial forceps” is a tentative attempt at forceps extraction after correction of malposition. It is undertaken with the reservation that the extraction will not be done if resistance is greater than can be easily overcome.
3. Ideal force to be generated during traction in obstetric forceps delivery
a) 20-30 pound
b) 30- 45 pound
c) 45-60 pound
d) 60 -70 pound
e) Mild to moderate force
Correct Answer: b and e. It is difficult to teach how much traction to be applied. Ideal is 30 – 45 lb. Juniors can be trained by strength testing unit to reproduce and not to exceed ideal traction force of 30 – 45 lb. So the basic principle remains “mild to moderate” force. “Visual feedback” is also suggested for training to produce this force.Prev Next
"Authored By Dr.Niraj Mahajan"
MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.Read more [+]