Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 10 , ISSUE 4S1 ( October-December, 2018 ) > List of Articles


Outlet Forceps Delivery: Role in Modern Obstetric Practice

Poonam Jaiswal, Sunita Agrawal, Arun K Dora

Keywords : Fetal outcome, Instrumental delivery, Maternal injuries, Outlet forceps, Prospective cohort study

Citation Information : Jaiswal P, Agrawal S, Dora AK. Outlet Forceps Delivery: Role in Modern Obstetric Practice. J South Asian Feder Obs Gynae 2018; 10 (4S1):328-334.

DOI: 10.5005/jp-journals-10006-1617

License: CC BY-NC 4.0

Published Online: 01-01-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Aim: The dramatic rise of cesarean section rate is a global problem. The forceps delivery has also led to numerous litigations due to poor fetal and sometimes maternal outcome. Still, it is having a prominent role to reduce the rate of cesarean section deliveries. The aim of this study was to assess feto maternal outcome in outlet forceps delivery. Methods: A prospective cohort study of 92 patients who delivered by outlet forceps conducted in the department of obstetrics and gynecology, Jawaharlal Nehru Hospital and Research Centre, Bhilai, Chhattisgarh, India. The result was analysed for Fetomaternal outcome over a period of 1 years from 15 October 2015 to 14 October 2016. Results: Incidence of Wrigley's outlet forceps delivery is 2.76% in our study. The most common indication was nonreassuring fetal heart rate (40.21%). Nearly 70.65% babies had normal APGAR score. 43.48% neonates had birth weight between 2.5–3 kg. Neonatal morbidities found in this study were impression marks over face in 18.47%, convulsions in 6.52%, neonatal hyperbilirubinemia and subconjunctival hemorrhage in 3.26% each, hypoxic ischemic encephalopathy in 2.17% and facial palsy in 1.09% neonates. Only 5.43% neonates required NICU stay of more than seven days. Extended episiotomy was observed in 6.76% and only three patients had atonic PPH. Cervical tear, first-degree perineal tear, traumatic PPH and vulvovaginal hematoma were observed in 2.7% patients each. 1.35% patients had a paraurethral tear, second and third degree perineal tear each. No maternal or fetal mortality due to forceps found in our study. Conclusion: Use of forceps is a safe alternative to cesarean section deliveries. The rates of maternal and perinatal morbidity and mortality in outlet forceps delivery are negligible and comparable to normal delivery in experienced hands.

PDF Share
  1. Bailey PE. The disappearing art of instrumental delivery. Int J Gynaecol Obstetr 2005;91:89-96.
  2. Villar J, Carroli G, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery. Multicentre Prospective Study BMJ. 2007;335(7628):1025.
  3. Lumbiganon P, Laopaiboon M, et al. Method of delivery and pregnancy outcomes in Asia. The WHO global survey on maternal and perinatal health 2007-08. Lancet 2010;375(9713): 490-499.
  4. Dennen PC. Outlet forceps procedure. In: Dennen PC, eds. Dennen's forceps deliveries, 3rd ed. F.A, New York: Davis Company; 1989: 188
  5. Iyengar SP, Patel MS. A study of outlet forceps in modern era. Int J Adv Med 2015;2:346-349.
  6. Shekhar S, Rana N, et al. A prospective randomized study comparing maternal and fetal effects of forceps delivery and vacuum extraction. J Obstetr Gynaecol India 2013;63(2):116-119.
  7. John LB, Nischintha S, et al. Outcome of forceps delivery in a teaching hospital: A 2 year experience. J Nat Sci Bio Med 2014;5(1):155-157.
  8. Lamba A, Kaur R, et al. An observational study to evaluate the maternal and neonatal outcome of forceps delivery in a tertiary care government hospital of a cosmopolitan city of India: Int J Reprod Contracept Obstet Gynecol 2016; 5:292-295.
  9. Chaudhari P, Bansal N, et al. A comparative study of feto-maternal outcome in instrumental vaginal delivery at tertiary health level hospital in Uttarakhand state. Int J Reprod Contracept Obstet Gynecol 2016;5:3294-3299.
  10. Ayala-Yáñez, Rodrigo et al. Forceps, actual use, and potential cesarean section prevention: study in a selected mexican population. J Preg 2015;(2015):489267. PMC. Web. 31 Oct. 2017.
  11. Werner EF, Janevic TM, et al. Mode of delivery in nulliparous women and neonatal intracranial injury. Obstet Gynecol 2011 Dec;118(6):1239-1246.
  12. Saini VK, Kawad KD, et al. Outlet forceps in modern era-study of 50 cases-clinical observation study. Int J Scien Res 2013;2(4).
  13. Singh A, Rathore P. A comparative study of feto maternal outcome in instrumental vaginal delivery. J Obstetr Gynecol India 2011;61(6):663-666.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.