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PubMed2003

[Delivery by forceps: indications and materno-fetal morbidity].

A retrospective study concerning patients having had a delivery by means pair of forceps over a period going from 1st Jun 1999 to 31st December 2000. The frequency of the use of forceps for delivery is 4.95%. The defect of eviction was an indication of the pair of forceps. Fetal suffering was the main indication. Maternal morbidity was represented essentially by a more or less injury of the genital tract with a rate of 11.1%. The rate of neonatal mortality is 1.28%. The maternal improvement of the maternal and fetal prognosis depends on an accurate indication of the use of forceps. In certain circumstances, mainly in fetal suffering, it is often difficult to choose between the high way and the low way.

Extraction, Obstetrical↗
PubMed1991

[Management of persistent posterior occipital presentation. 253 extractions by forceps].

A retrospective study of the notes of 253 deliveries was carried out in the two maternity units attached to the University of Rennes between 1980 and 1985. This followed a review of the literature on delivery of babies presenting with a persistent occipito posterior position. Tarnier's forceps were used in each case with full rotation of the presenting part carried out or else delivery in the occipito posterior position. There were five cases of failed forceps. We have not been able to show that there was a significant statistical difference as far as the neonatal state of the babies was, because to the methods of delivery. On the other hand, there was a greater frequency of urinary-vaginal lesions after full rotation. We therefore suggest that a trial of forceps delivery should be carried out in the operating theatre when the optimal obstetrical conditions have been fulfilled, so long as the manoeuvres are carried out technically easily and so long as Caesarean section is resorted to if all the obstetrical conditions are not fulfilled, or if it seems difficult to deliver the baby with a forceps.

Cesarean Section↗
PubMed1991

Validation of the 1988 ACOG forceps classification system.

In February 1988, an ACOG Committee Opinion substantially revised the classification of forceps operations. The revision addressed two significant shortcomings of the old system: Outlet forceps had been defined too narrowly and midforceps too imprecisely. We now report the results of a prospective study of 357 forceps deliveries classified using each system. Allowing up to 45 degrees of rotation in an outlet forceps delivery did not increase morbidity measured by any criterion. Dividing the old midforceps group by precisely identifying station and rotation permitted greater stratification of the risks of short-term neonatal and maternal morbidity. We conclude that our results validate the 1988 classification scheme.

Birth Injuries↗
PubMed1989

Comparison of midforceps, low-forceps, and spontaneous vaginal deliveries.

A prospective, six-month study compared various maternal and neonatal parameters among spontaneous vaginal (n = 47), low-forceps (n = 21), and midforceps (n = 15) deliveries. All three groups had good neonatal and maternal outcomes. The only significant differences (P greater than .01) were the one-minute Apgar scores between the low-forceps and midforceps groups and parity between the spontaneous vaginal and low-forceps deliveries. The findings did not reveal poorer neonatal outcomes or excessive maternal morbidity, thus supporting the continued use of forceps in properly selected patients.

Adolescent↗
PubMed1980

Rotational forceps in midforceps delivery.

A series of consecutive midforceps rotations performed using purely rotational forceps is anslyzed. Leff forceps were designed to make forceps application less difficult and rotation less traumatic to mother and fetus. In many cases, rotation was done under local anesthesia and delivery was completely by traction with Simpson or outlet forceps. Cesarean section was done in 4 cases in which easy rotation and delivery were not possible.

Birth Injuries↗
PubMedDate not supplied

Relationship of difficult forceps delivery to dental arches and occlusion.

This study examined the relationship between the extensive use of forceps procedures during delivery and later occlusal characteristics. The work uses data collected in National Collaborative Perinatal Research Project (USA), in which more than 60,000 pregnancies and the children's health were followed by regular medical tests and examinations. Of these, a subsample of 2,074 children participated in dental examinations, including the production of dental casts with wax bites to register occlusion. A total of 84 children, 55 boys and 29 girls, were coded as having undergone difficult or very difficult forceps deliveries. A control group was matched by age, sex, race, and site of dental examination. The results show a significant increase in asymmetric molar occlusion (P < 0.005) and canine relations (P < 0.001) in the study group. The sagittal length of the mandibular arch was increased in the difficult forceps delivery group (P < 0.01). In conclusion, difficult forceps procedures are associated with a later asymmetric occlusion.

Birth Injuries↗
PubMed1993

Survey of forceps delivery in North America in 1990.

OBJECTIVE: To determine whether opinions and practice patterns have markedly changed over the past decade and whether clinicians are cognizant of the new ACOG definitions for forceps deliveries. METHODS: Two hundred ninety-five United States and Canadian residency programs were surveyed via a questionnaire; 203 (69%) responded. Statistical analysis was performed using the chi 2 test, Yates correction factor, and the extended Mantel-Haenszel test. RESULTS: All but two program directors (99%) were familiar with the new definitions, which were being used by 162 (80%) of the programs. All institutions used outlet and low forceps, although 14% no longer performed midforceps deliveries. Attending faculty were the primary instructors in 67% of United States and 100% of Canadian programs. Simpson forceps were the most commonly used for outlet (46%) and low (43%) forceps deliveries. Kielland (27%) and Simpson (24%) instruments were most commonly used for midforceps deliveries. CONCLUSION: Although the rate of midforceps use decreased, operative vaginal delivery was still commonly taught in residency programs in North America in 1990.

Canada↗
PubMed1998

[The introduction of obstetric forceps in Norway--a 250-year anniversary].

Johan Gottfried Erichsen (1713-68), born in Germany and chief medical officer in Bergen from 1747, was probably the first to perform a forceps delivery in Norway, on 14 February 1748. The mother, who had been in labour for five days, survived; the child, however, did not. The obstetric forceps had been a secret in the Chamberlen family and had become more widely known only a few decades earlier. Erichsen, who was the first man-midwife in Norway, had learned obstetrics in Paris by the younger Grégoire. He mastered both the techniques of internal version and forceps delivery. This article describes Erichsen's medical and obstetric background and his qualifications for operative obstetrics. He worked in the period when the obstetric forceps changed obstetrics, birth delivery became an arena also for men, and a part of medicine. Obstetrics was established as a science and physicians had a tool whereby also children could be saved during complicated delivery.

Female↗
PubMed1987

Modified vitreoretinal forceps for membrane peeling.

We have designed a modified vitreoretinal forceps specifically for peeling delicate epiretinal membranes in cases of premacular fibroplasia. Improved features of the forceps include a positive-action closure, barrel design, and lightly serrated surfaces. Rotational movements are made easier by this modified forceps design. Over the past three years, 96 cases of premacular fibroplasia have been successfully managed with the modified forceps. Delicate membranes have been removed without tearing or shredding.

Humans↗
PubMed1995

Chorionic villus sampling by biopsy forceps. Results of 1580 procedures from a single centre.

The results of a prospective series of 1580 chorionic villus sampling (CVS) procedures using biopsy forceps are presented. Most of the procedures (1442), including 11 sets of twins, were performed by the transcervical approach (TC-CVS), using a curved-shank thin forceps, and 138 by the transabdominal approach (TA-CVS), using a trocar-guided straight thin forceps. The mean gestational age for TC-CVS was 10.9 weeks, and in 233 cases (16 per cent) the procedure was carried out between the 12th and 14th weeks. The mean gestational age for TA-CVS was 16.7 weeks. The major indication for CVS was advanced maternal age (92.7 per cent in the TC and 91.8 per cent in the TA approach), and indications for abnormal ultrasound findings were more common in the TA approach (4.5 per cent) than in TC-CVS (0.07 per cent). Although sampling was apparently accomplished in all the procedures, in 3.1 per cent of the TC-CVS and 2.2 per cent of TA-CVS procedures, the samples were less than 1 mg after dissection. A cytogenic report was obtained in 96.1 per cent of the TC-CVS and 90.6 per cent of the TA-CVS. Maternal serum alpha-fetoprotein (MSAFP) was measured before and after TC-CVS and the post-CVS MSAFP was positively correlated with the sample weight. Second-trimester amniocentesis following CVS was required in 5.2 per cent (TC-CVS) and 6.5 per cent (TA-CVS), due to the failure to obtain a cytogenetic report or diagnostic confirmation. The follow-up to the 20th week was 100 per cent by ultrasound scan, and 88.6 per cent from the 21st week to 1 week after delivery. Fetal loss rates within 2 weeks of the procedure were 1.7 per cent (TC-CVS) and 0.8 per cent (TA-CVS) and total fetal loss accumulated to 1 week after delivery was 4.6 per cent (TC-CVS) and 5.9 per cent (TA-CVS). Factors found to increase significantly fetal loss in the TC-CVS series were maternal age and the collection of very small samples, but not the number of forceps insertions.

Adult↗
PubMedDate not supplied

Endomyocardial biopsy in heart-transplanted children: comparison of sheaths to guide biopsy forceps.

The risk of perforation during 65 endomyocardial biopsies (380 specimens) was investigated using two different sheaths to guide the biopsy forceps in five heart-transplanted children aged 1.6-12.9 years. One of the sheaths guided the biopsy forceps simply into the right ventricle (prefabricated 110 degrees curved tip); the other (specially curved sheath) had two curves, the distal one of which guided the forceps posteriorly toward the interventricular septum. The position of the sheath was evaluated by biplane fluoroscopy and, in children </=4 years of age, also by transesophageal echocardiography (TEE). Perforation was defined as clinical perforation (chest pain and pericardial effusion as judged by transthoracic echocardiography or TEE) and "near perforation" (epicardial fat in specimens). The prefabricated sheath was associated with 10 incidents of perforation (one clinical and nine near perforations) after 16 biopsies and 96 specimens (10.4%) compared with 2 near perforations after 49 biopsies and 284 specimens (0.7%) after using the specially curved sheath (p < 0.001). We conclude that the risk of perforation during endomyocardial biopsy can be reduced by using a specially curved sheath to guide the biopsy forceps toward the interventricular septum.

Adolescent↗
PubMed1991

The interaction of electrosurgical bipolar forceps and generators on an animal model of fallopian tube sterilization.

Electrosurgical tubal sterilization with bipolar forceps has shown a variable and, in certain studies, a high failure rate. Some physicians have questioned if failure rates are due to an incompatibility between bipolar forceps and bipolar generators of different manufacturers. This manuscript presents data on tissue desiccations performed on a rat uterine horn model that uses two bipolar forceps of quite different designs and two popular bipolar generators. The data demonstrate that if an appropriate amount of energy, between 100 and 117 J, is applied to the tissue, consistent destruction occurs, regardless of the generator-forceps combination used. Histologic examination of the desiccated uterine horns displayed complete occlusion of all samples 8 weeks after the procedure. However, immediately and at 3 weeks after the procedure patent uterine horns were found. In the patent samples most samples displayed considerable electrosurgical damage.

Animals↗
PubMed1989

Chorionic villus sampling (CVS). Randomized study of efficacy of two transcervical biopsy methods: aspiration canulas and small forceps.

A randomized study of two transcervical biopsy methods was performed. One method involved the use of an aspiration catheter and the other a tissue biopsy forceps. 120 chorionic villus samplings were performed in 30 patients. The percentage of success in taking biopsies and the resulting number of karyotypes were identical in both groups. The amount of removed trophoblastic tissue was greater when the forceps was employed. When the aspiration catheter was used, a sufficient amount of trophoblastic tissue was obtained for karyotyping purposes. It was easier to insert the aspiration catheter than the forceps. The echogenicity of the catheter and forceps were identical. The aspiration catheter has two advantages. Firstly, it is malleable and fits to the anatomy of the cervical canal and the site from which the biopsy is to be taken. Secondly, it is disposable.

Adolescent↗
PubMed2005

Management of mandibular angle fractures using the mandibular angle reduction forceps.

The aim of this study was to determine whether or not the use of the mandibular angle reduction forceps decreases the incidence of post-operative complications. Forty-six patients, who presented with mandibular angle fractures with a displacement or dislocation, were randomly divided into two treatment groups. Both groups underwent an open reduction with a single upper border miniplate and screw fixation. For 23 patients, the mandibular angle reduction forceps was used to aid in fracture reduction, and for 23 patients, the reduction of the fracture was achieved using IMF. The post-reduction radiographs showed that the reduction forceps group had a higher proportion of precise anatomic alignment of fracture than those in the IMF group. In addition, the former group showed a lower rate of post-operative complications, as compared to the latter group. This study found that the use of the mandibular angle reduction forceps is an important factor for decreasing the incidence of post-surgical complication.

Adolescent↗
PubMed2004

Magill forceps technique for removal of safety pins in upper esophagus: a preliminary report.

OBJECTIVE: Foreign body ingestion is not an uncommon problem in children. Children can ingest various foreign objects. One of such objects is safety pin, which is not widely reported in the literature. The purpose of this study is to consider the efficacy of Magill forceps for removal of safety pins from upper esophagus. METHODS: A retrospective chart review was conducted for all children admitted to our hospital with safety pin ingestion from 1995 to 2003. In 58 children who had been found to ingest safety pin, the attachment site was gastrointestinal tract. In 12 of the cases, safety pins were located in the upper end of the esophagus. In seven of the children safety pin extraction was achieved by using a Magill forceps with the assistance of a laryngoscope maintaining general anesthesia with mask inhalation. RESULTS: Safety pins were successfully removed with Magill forceps without any complications in seven patients whom they were located in the upper esophagus. Upper esophageal safety pins in the other five patients were extracted with rigid esophagoscopy for they were not seen under direct laryngoscopy. There were no complications. CONCLUSIONS: This is a preliminary report, but we believe that the Magill forceps technique for the removal of safety pin in the upper end of the esophagus is safe and minimally invasive method compared to rigid esophagoscopy.

Child↗
PubMed1999

Grasping forceps assisted endoscopic resection of large pedunculated GI polypoid lesions.

BACKGROUND: Endoscopic resection of pedunculated polyps with heads 1 cm or greater in diameter is technically complex. To facilitate removal of such polyps, we developed grasping forceps assisted endoscopic resection in which we use a detachable snare to prevent polypectomy-related bleeding and evaluated the usefulness and safety of the procedure. METHODS: Ten patients with pedunculated polyps with heads 1 cm or greater in diameter were treated with this technique. A two-channel endoscope, grasping forceps, electrosurgical snare, and detachable snare are needed for the procedure. RESULTS: All lesions were easily and safely resected. During this procedure, a two-channel endoscope with grasping forceps proved to be satisfactory for handling the detachable snare and the electrosurgical snare and for accurate recognition of the stalk under good visual control. No hemorrhage, perforation, or other complication occurred as a result of use of this new technique. CONCLUSIONS: Grasping forceps assisted endoscopic resection of polyps with a detachable snare is an effective method for the prevention of polypectomy-associated bleeding. This technique makes it technically easier to resect large pedunculated polypoid lesions of the GI tract.

Aged↗
PubMed1985

Biopsy-coagulation forceps to simplify biopsy of the bladder.

Until now the forceps used for biopsy of the bladder has required a second procedure to coagulate the bleeding resulting from tissue removal. A new biopsy forceps is described, which makes it possible to perform the biopsy and coagulation simultaneously, thus, eliminating the inconvenience of having to change instruments during the operation. The shaft of the forceps through which the high frequency current flows is insulated completely so that the current exits only via the tips of the prongs. This design eliminates the danger of the specimen being subjected to thermal damage. The advantages offered by the new forceps are vision remains good, orientation is facilitated, loss of blood is minimal, operation time is reduced and the necessity of changing instruments is eliminated.

Biopsy↗
PubMed1996

Forceps for capsulorhexis.

Conventional continuous curvilinear capsulorhexis (CCC) by forceps is connected with use of viscoelastics. A new model of forceps allows CCC without a viscoelastic and has the advantage of a bent-needle cystotome because the terminal part of the instrument is the size of a bent needle. The instrument retains the forceps' ability to grasp tissue firmly and prevents anterior chamber collapse during CCC. I performed the CCC using the new forceps without a viscoelastic in 198 eyes.

Anterior Chamber↗