(b) Brain damage and intracranial hemorrhage.
(d) Facial paralysis.
(e) Cord compression.
c. Conditions for Forceps Delivery. The following conditions must occur for
successful forceps delivery.
(1) Fully dilated cervix. Severe lacerations and hemorrhage may ensue if a
rim of cervical tissue remains.
(2) Head engaged. The extraction of a mature fetus with a "high"
(unengaged) head usually is disastrous.
(3) Vertex presentation or face presentation. Other presentations require
Membranes ruptured. This will ensure a firm grasp of the forceps on the
(5) No cephalopelvic disproportion. If there is engagement, there must be
no outlet contracture or gross sacral deformity.
Empty bladder and bowel. This will avoid laceration and fistula
d. Levels of Forceps Application. The station of the fetal head determines the
level of forceps application and, generally, the relative difficulty to be expected in
(1) High forceps. The biparietal diameter of the vertex is above the ischial
spines (the head has not yet engaged) when the forceps are applied. High forceps
delivery is an exceedingly difficulty and dangerous operation for both patient and fetus
and is rarely done.
(2) Midforceps. The vertex is at the ischial spines, almost to the ischial
tuberosities on application of the forceps. The delivery often is difficult, depending on
the size of the vertex, its position, and the pelvic architecture and diameters. A
cesarean birth is preferred to a potentially difficult midforceps delivery.