Forceps are handheld instruments used widely across medical disciplines for precise actions that human fingers cannot perform. They operate using the mechanical principle of a lever, employing two crossed blades or branches to provide controlled grasping or clamping. Forceps are designed for manipulating tissue or objects within the body during numerous diagnostic and surgical procedures. The specialized design of the tips allows a practitioner to apply highly controlled pressure and movement. Forceps are generally categorized as either non-locking, which act like tweezers, or locking, which utilize a ratchet mechanism to maintain a steady grip without continuous hand pressure.
Applications in General Medical Procedures
The function of medical forceps outside of childbirth centers on three primary mechanical actions: grasping, clamping, and manipulation. Many types of non-locking instruments, often called tissue forceps, are designed with fine serrations or teeth to grasp and hold delicate tissues during surgery. For instance, Adson forceps, with their narrow, fine tips, allow surgeons to handle skin edges and soft tissue with minimal trauma during wound closure or dissection.
Forceps are also used for clamping blood vessels to control hemorrhage, a function performed by hemostatic forceps, commonly known as hemostats. These instruments feature a locking mechanism that allows them to securely occlude a vessel, temporarily stopping blood flow until the vessel can be tied off or cauterized. Different sizes, such as mosquito or Kelly forceps, are used depending on the diameter of the vessel and the required depth of the surgical field. This ability to instantly control bleeding is a routine function in nearly every surgical environment.
Forceps are also used extensively for detailed manipulation and extraction of foreign bodies or materials. In non-surgical settings, specialized splinter forceps are used to retrieve small objects embedded in the skin. In procedures like dentistry, extraction forceps securely grasp and remove teeth from the alveolar socket. The diverse array of forceps designs ensures a suitable tool exists for controlled access and manipulation across all areas of the body.
Role in Facilitating Childbirth
Obstetric forceps represent a specialized application, safely guiding the fetus through the birth canal during a difficult second stage of labor. A primary indication for their use is to expedite delivery when the mother is exhausted and cannot continue effective pushing efforts. Forceps are also employed when there is evidence of fetal distress, such as a non-reassuring fetal heart tracing, and rapid delivery is necessary to prevent oxygen deprivation.
The instrument is comprised of two specialized blades. Each blade has a cephalic curve to cradle the baby’s head and a pelvic curve to conform to the shape of the mother’s birth canal. The mechanism involves the practitioner placing the blades around the fetal head and applying gentle traction in coordination with the mother’s contractions. This guided assistance reduces the time the baby spends in the birth canal, mitigating the risks associated with a prolonged labor.
A further purpose of obstetric forceps, particularly certain types like Kielland forceps, is to correct fetal malposition. If the baby’s head is not properly aligned for descent, the forceps can be used to gently rotate the head to an optimal position before traction is applied. This rotational capability distinguishes them from general surgical instruments. The entire procedure is an assisted vaginal delivery method, often used as an alternative to an emergency cesarean section when the baby’s head has descended significantly into the pelvis.
Potential Complications and Patient Safety
The use of forceps, while intended to improve delivery outcomes, carries inherent risks that must be weighed against the consequences of prolonged labor or immediate surgical delivery. For the birthing parent, the most common complications involve trauma to the lower genital tract. Forceps-assisted deliveries have a higher association with severe perineal tears, specifically third- and fourth-degree lacerations that extend into the anal sphincter or rectal mucosa.
Other maternal risks include injury to the bladder or urethra, and an increased risk of postpartum urinary incontinence or pelvic organ prolapse. These complications arise from the additional pressure and necessary widening of the birth canal structure during the extraction process. Providers must ensure that the cervix is fully dilated and the fetal position is accurately assessed to minimize these risks before application.
For the newborn, complications are often temporary, though more serious injuries can occur. Minor trauma typically includes superficial bruising, abrasions, or temporary marks (ecchymosis) on the baby’s head or face where the blades were applied. A more specific risk is temporary facial nerve palsy, which manifests as weakness or drooping on one side of the face and typically resolves within a few weeks. Although rare, serious issues like minor skull fractures or intracranial hemorrhage are potential hazards that emphasize the importance of expert training and careful technique.