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The eighteenth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
The use of the obstetric forceps meant that in difficult cases the man-midwife no longer had to conduct version and breech extraction, or delivery with instruments which would critically injure or kill the fetus. Many types of forceps were introduced throughout the century and the modified instruments offered greater ease of use and safety for both mother and infant. Midwives, however, did not convert to using the obstetric forceps, so contributing to the rapid development of a separate class of ‘instrumentalist’ man-midwives. The story of the evolution of obstetric forceps was provided by Kedarnath Das (1929) and by Walter Radcliffe (1947).
Practice circuit 1
Published in T. Justin Clark, Arri Coomarasamy, Justin Chu, Paul Smith, Get Through MRCOG Part 3, 2019
T. Justin Clark, Arri Coomarasamy, Justin Chu, Paul Smith
Questions to be asked: Give the candidate the Kielland’s forceps (Figure 10.1). Ask the candidate to identify the instrument and to name the key features that facilitate their use (rotational mid-cavity forceps delivery).Give the candidate the Neville Barnes obstetric forceps (Figure 10.2). Ask the candidate to identify the instrument and to give the indications for its use.As a skilled trained operator or obstetric forceps, what are the clinical pre-requisites for their safe use.Give the candidate the Neville Barnes obstetric forceps and hold the pelvic model with the foetal doll in a DOA position at +1 station. Ask them to demonstrate a forceps delivery.
The art and science of surgery
Published in Lois N. Magner, Oliver J. Kim, A History of Medicine, 2017
Aveling claimed that William Harvey, who discovered the circulation of the blood, had rescued English midwifery from its place as the most despised part of the medical profession. But it would be more accurate to say that it was a monopoly on the obstetrical forceps and other surgical implements that was responsible for male domination of the field rather than Harvey's studies of embryology. The origins of the obstetrical forceps are obscure, although the instrument seems simple enough in form and function. All that is known with certainty is that the “hands of iron” evolved from surgical instruments of death. Before surgeons adopted the obstetrical forceps, they could do little more than kill and extract an impacted fetus with knives, hooks, perforators, and lithotomy forceps, or attempt cesarean section on a moribund woman. By the early eighteenth century, medical men had several versions of the obstetrical forceps, with which they could deliver a live, if somewhat squashed, baby. The instrument invented by a member of the Chamberlen family allowed four generations of Chamberlens to enjoy a lucrative midwifery practice.
Extraperitoneal versus transperitoneal cesarean section: a retrospective study
Published in Postgraduate Medicine, 2023
Chao Ji, Meng Chen, Yichen Qin
The traditional method of head delivery requires repeated pressure of the uterine fundus, which increases the pain of puerpera and may increase the rate of surgical complications, indirectly affecting prognosis. A longer time for fetal head delivery leads to a higher risk of complications, such as neonatal asphyxia and amniotic fluid inhalation syndrome caused by external stimulation to the fetus [19]. Therefore, the fetal head should be delivered quickly after uterus incision and the respiratory tract should be fully cleaned. One major difficulty of ECS is the delivery of the fetal head. In this study, no significant impact of ECS was presented on the measurable parameters of the newborn, which might be attributed to the use of obstetric forceps in our hospital for fetal head delivery. The left and right leaves of forceps are, respectively, placed on the left and right sides of the fetal head, and a sufficient and smooth force is used to deliver the head. This approach can effectively shorten the delivery duration of the fetal head.
The impact of sexual intercourse during pregnancy on obstetric and neonatal outcomes: a cohort study in China
Published in Journal of Obstetrics and Gynaecology, 2019
The clinical data (age, body height, pre-gestational body weight, gravidity and parity, history of CS, and application of assisted reproduction), delivery modes, pregnancy complications, and the perinatal outcomes of mother and newborn were collected by retrospectively reviewing the participant and neonatal electronic medical records (created by DTHealth 6.9.4 ©2011 DTHealth). The medical records of infant examinations at the ages of 6 weeks and 6 months were used. All of the data were gathered in Excel tables by a trained nurse (Miss T. Li) and checked again by Dr. L. Li. These items are shown in Table 3. At PUMCH, we collected vaginal swabs at approximately 36 weeks of gestation or immediately after the natural rupture of membranes for all women. Hence, we had information about vaginal infections involving vulvovaginal candidiasis (VVC) or group B streptococci (GBS). Vacuum extraction was applied as needed for surgical delivery, and obstetric forceps were not employed at PUMCH. For puerperal conditions not found in the electronic medical records (wound infections and endometritis), Miss T. Li and Dr. L. Li verified the participant complaints throughout the patient and emergency room medical records.
Iris vessel dilation and hyphema due to forceps trauma in a newborn
Published in Journal of Obstetrics and Gynaecology, 2019
Alexandra Tantou, Maria Kotoula, Petros Koltsidopoulos, Evangelia Tsironi, Eleni Papageorgiou
A wide spectrum of anterior and posterior segment ophthalmic injuries has been described secondary to instrumental vaginal deliveries, which may be self-limiting or cause a significant long-term visual impairment (Jain et al. 1980; McAnena et al. 2015). Ocular complications secondary to an obstetric forceps injury include a periorbital bruising, lid lacerations, subconjunctival haemorrhage, Descemet’s tear and hyphema, oculomotor and facial nerve palsy, vitreous haemorrhage, choroidal rupture and globe rupture (Jain et al. 1980; McAnena et al. 2015). We report the rare case of a neonate who presented with a bilateral iris vessel dilation and hyphema due to their forceps-assisted delivery.