Forceps delivery: Contemporary tips for a classic obstetric tool

摘要

Operative vaginal delivery remains an important skill for obstetricians to provide the full spectrum of care for pregnant patients. It can reduce the need for cesarean deliveries, an important goal of both our specialty nationwide and of individual providers and patients. Notably, 2017 was the first year the cesarean delivery rate increased since 2009, suggesting an even greater urgency in focusing on tools to reduce it. The top two reasons for cesarean delivery - labor dystocia and abnormal or indeterminate fetal heart rate tracings - can both potentially be resolved by operative vaginal delivery. Despite this, the overall trend for operative deliveries has shown a dramatic decline. While approximately 10% of deliveries were performed via operative delivery in the 1990s, the most recent National Vital Statistics Survey shows a 2.58% rate for vacuum deliveries and 0.56% for forceps deliveries. It is these latter deliveries - forceps-assisted vaginal deliveries - which will be the focus of this article.