Forceps (Ergonomic Operation): An Effective Aid for Fetal Head Delivery during Cesarean Section

Abstract

Aims and objectives: To focus on comparison of forceps-assisted vs manual method of fetal head extraction during lower segment cesarean section (LSCS). Comparative study to identify the safety, effectiveness, and ease of obstetric forceps for delivery of head in cesarean section. Methods and materials: After getting ethics approval, the total 66 mothers from the ANC, attending antenatal OPD, and Emergency admitted for cesarean section in different indications fulfilling the selection and exclusion criteria. These were selected, randomized, and allowed into two groups such as group A (n = 33) = cases (forceps) and group B (n = 33) = controls (manual) in each group consisting of 33 patients. The data collection, data analysis, and the outcomes of individual groups analyzed as primary outcomes, secondary outcomes, newborn outcomes were tabulated and statistically significant calculated by GRAPH-PAD software. Results and analysis: In our study, the primary outcomes were statistically significant as weight, BMI, estimated intraoperative loss, drain volume in 48 hours, the weight of mops, PCV-drop, and the hemoglobin drop complicated with chest discomfort, required transfusion as blood, FFP, platelets, volume expanders needed intensive and/or critical care. The outcomes were significant in operation time with U-D time, difficulties head delivery and assisted fundal pressure, required conversion and ultimately failure to deliver. Intraoperative events were significant as extension/laceration-associated angle hematoma, stitch line hematoma, window at stitch site, cut through and apposition failure with major hazards landed in major operations. The indicators of the secondary outcomes in postoperative and follow-up period were revealed statistically significant as mobilization time, oral feeding time, pain and discomfort, analgesics requirement, developed febrile illness, and wound complications necessitated hospital stay with recovery-satisfaction and costs. The newborn outcomes were observed significant in form of I-D time, meconeum stain, weight, preterm, IUGR, cried at birth with Apgar score, needed essential newborn care (ENC), and NICU admission. Conclusion: Considering the outcomes, with proper selection of patient(s), application of forceps produced statistically significant better outcomes during cesarean operation than manual extraction. Recommended routine forceps application in cesarean delivery.