A Review of the Role of Instrumental Delivery in Modern Obstetrics

Abstract

Instrumental vaginal delivery (forceps and/ or ventouse) has been a tool for termination of second stage of labor (full dilatation of cervix), and is indicated in any condition threatening the mother or fetus. In order to minimize maternal and fetal risks, we must know indications, contraindications, application, and use of the particular instrument. With rising caesarean section rates, a better understanding of relevance of these techniques will help selected patients. Caesarean section in the second stage of labour is a technically difficult procedure, especially when the fetal head is deeply impacted within the pelvis. Safe instrumental vaginal birth requires a careful assessment of the clinical situation and clear communication with the mother. Instrumental birth should be performed by or in the presence of, an operator with expertise in the chosen procedure and the management of any complications which may arise. Recognition of when it is appropriate to abandon the procedure and consider an alternative method of birth is vital. If selected wisely, there is very low morbidity and mortality. It is very necessary to make instrumental vaginal delivery available and accessible in a low resource country like India and our healthcare personnel should be trained.