The natural process of delivery is difficult and sometimes unpredictable. Often there are situations where for the preservation of the life of the child and the mother should be as soon as possible to complete the birth. In this case, the obstetrician-gynecologist urgently decides on the imposition of obstetric forceps.
Obstetric forceps - a bit of history
For the first time obstetric forceps were created by P. Chamberlain, who kept the instrument secret and used for personal enrichment.
The public was the forceps, secondarily invented 125 years later by surgeon Palfin. It was from this moment (1723) that obstetric forceps began to be applied and improved first in European countries, and then in Russia and other post-Soviet republics.
Until the moment when cesarean section surgery entered the obstetrical practice, obstetric forceps were the only means by which the life of many babies and women in childbirth was saved, including.
Obstetric forceps - types and technique of application
To date, in total, there are more than 600 models of obstetric forceps that differ in their structure and nature of application.
Depending on the location of the fetal head, the forceps are classified:
- Output obstetrical forceps (typical) - superimposed on the head, a large segment of which is located in the plane of the exit of the small pelvis. The imposition of output obstetrical forceps is rarely practiced, since in this position of the head one can dispense with an episiotomy.
- Hollow obstetrical forceps (atypical) are required if the head is located directly in the cavity of the small pelvis.
- High obstetrical forceps were previously practiced when the head was at the entrance to a small pelvis. The application of high forceps is a dangerous and complex procedure, leading to severe birth complications, which is why it is currently banned.
As a rule, classical models of forceps consist of two symmetrical spoons, a lock and a handle.
By the degree of mobility of the lock - the connecting element, obstetric forceps can be divided into:
- Russian (the castle is quite mobile);
- German (the castle is almost motionless);
- English (moderate mobility);
- French (fixed castle).
In our country, the most commonly used English obstetrical forceps Simpson in the modification of the obstetrician Phenomenov, with the same name Simpson-Phenomenov. This model consists of two parts - the right and left spoons, which have two curvatures (head and pelvic), a movable lock, a ribbed handle with Bush hooks for fixing the hands. The weight of the forceps is 500 grams, the length is about 35 cm. The principles of superimposing obstetric forceps depend on the characteristics of the instrument, and in particular on whether the output or cavity model.
Obstetric forceps - evidence and consequences
The main indications for applying forceps are:
- diseases of the cardiovascular system, kidneys, heart of a woman incompatible with the burden of labor;
- weak labor activity;
- acute fetal hypoxia ;
- prolapse of umbilical cord loops;
- premature detachment of the placenta and many others, at the doctor's discretion.
Also for the procedure there are the following conditions:
- a viable fetus;
- full disclosure;
- conformity of head and pelvis dimensions;
- absence of a fetal bladder.
In addition to the above features, it is worth noting that the procedure for imposing obstetric forceps is quite complex, and not all specialists have these skills in perfection. In addition, complications are possible, both on the part of the mother and the child. Namely:
- trauma of the birth canal, rupture of the cervix , and sometimes the uterus itself;
- trauma to the head and cervical region of the fetus;
- paresis of the facial nerve;
- hematomas;
- hemorrhages in the brain and many others.