Forceps deliveries and fetomaternal outcome in modern obstetrics


  • Sarda Devi Okram Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, India
  • Kalpana Betha Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, India
  • Jothsna Bodhanapati Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, India
  • Koorapati Tejasri Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, India



Forceps, Low birth weight, Postpartum haemorrhage


Background: In modern obstetrics practice has witnessed an increase in the caesarean section rates everywhere. The incidence of instrumental deliveries varies between 10-12% in UK. The incidence of instrumental deliveries varies between 2.7-5% in India. There is an urgent need to reintroduce instrumental need in the modern obstetrics. Instrumental delivery is one of the basic functions of emergency care according to WHO. This study was done to know the prevalence, indications and fetal outcomes of forceps deliveries.

Methods: A retrospective study was conducted at a tertiary teaching hospital, India from January 2014 to December 2018. All cephalic singleton pregnant mothers who underwent forceps delivery after 28 weeks were included. All the forceps delivery done in twins and breech vaginal delivery were excluded. Demographic data, Indication of forceps delivery, maternal complications of forceps delivery like episiotomy extension, cervical tear, vaginal wall tear, PPH and neonatal outcome like low birth weight, NICU admissions, stillbirth, APGAR score at 1 and 5 minutes were recorded. Equal number of mothers of reproductive age group 20-45 ages who underwent normal non breech vaginal deliveries were randomly selected as control.

Results: The prevalence of forceps delivery was 5.25%. The most common indication was fetal distress (55%). Most of the mothers were primigravidas in age group 20-30 years (p<0.001). Regarding the neonatal outcome, 72% of the babies were having weight >2.5 kgs.  APGAR <7 at 1 and 5 min was not significant.

Conclusions: As fetal distress is the most common indication, every obstetrician should learn the skill of forceps delivery and it should not be a dying art.


Spongy CY, Berghella V. Wenstrom KD. Preventing the first ceaserean delivery. Obstet Gynecol. 2012;120:1181-93.

Lindow SW, Hayashi R. Assisted vaginal delivery high risk pregnancy, 4th ed; 2011;72;1245-1259.

ACOG Practice Bulletin. Clinical management guidelines for obstetricians gynecologists. Pregestational Diabetes. 2005;105:675-685

Prameela RC, Asha MB, Prajwak S. Outcome of instrumental vaginal deliveries in referred cases. J Evolution Med Dental Sci. 2015;4(19):3275-80.

Lamba A, Kaur R, Muzafar Z. An observational study to evaluate the maternal and neonatal outcome of forceps delivery in a tertiary care government hospital of cosmopolitan city of India. IJRCOG. 2016;5(2):292-5.

Maine D, Wardlaw T, Ward V, McCarthy J, Birnbaum A, Akalin MZ, et al. Guidelines for monitoring the availability and use of obstetric services. World Health Organization Geneva; 1997.

Operative vaginal delivery. ACOG Technical Bulletin Number 196-- August 1994 (replaces No. 152, February 1991). Int J Gynaecol Obstet. 1994 Nov;47(2):179-85.

The American College of Obstetricians and Gynecologists, authors Operative Vaginal Delivery. Washington, DC: ACOG; 2000. (Practice Bulletin No. 17); 2000:1-7.

Ameh CA, Weeks AD. The Role of Instrumental Vaginal delivery in low resource settings. BJOG. 2009;116(1):22-5.

Shameel F, Bava A. Instrumental vaginal deliveries at tertiary centre. IJRCOG. 2016;5(12):4146-50.

Aliyu LD, Kadas AS, Hauwa MA. Instrumental vaginal delivery in bauchi, northeast Nigeria. J West Afr Coll Surg. 2011;1(4):18-27.

Demissie K, Rhoads GG, Smulian JC. Operative vaginal delivery, neonatal, infant adverse outcomes: population based retrospective analysis. BMJ. 2004;4:329-34.

Akhtar S. Comparison of maternal and infant outcome between vacuum extraction and forceps deliveries. Pak Armed Force Med J. 2006;2(1):25-31.

Karacam Z, Eroğlu K. Effects of episiotomy on bonding and mothers’ health. J Advanced Nursing. 2003;(43)4:384-94.

Lopamudra B, John S, Nischintha, Ghose S. Outcome of forceps delivery in a teaching hospital: A 2 year experience. JNSBM. 2014;5(1):155-7.

Nikolov A, Nashar S, Atanasova M, Dimitrov A. Indications for vaginal delivery with forceps application. Akush Ginekol (Sofiia). 2011;50:3-12.

Yeomans ER. Operative vaginal delivery. Obstet Gynecol. 2010;115:645-53.

Prapas N, Kalogiannidis I, Masoura S. Operative vaginal delivery in singleton term pregnancies: short term maternal and neonatal outcomes. Hippokratia. 2009;13:41-5.

Wen WS, Shiliang L, Kramer SM, Marcoux S, Ohlsson A, Sauvé R, et al. Comparison of maternaland infant outcomes between vacuum extraction and forceps deliveries. Am J Epidemiol. 2001;153:103-7.






Original Research Articles