Operative vaginal delivery remains a valid option when problems arise in the second stage of labor. The most common indications are fetal compromise and failure to deliver spontaneously with maximum maternal effort. There is a clear trend to choose vacuum extraction over forceps to assist delivery, but the evidence supporting that trend is unconvincing. Recent literature confirms some advantages for forceps (eg, a lower failure rate) and some disadvantages for vacuum extraction (eg, increased neonatal injury), depending on the clinical circumstances. To preserve the option of forceps delivery, residency training programs must incorporate detailed instruction in forceps techniques and related skills into their curricula. Simulation training can enhance residents' understanding of mechanical principles and should logically precede clinical work.
Operative vaginal delivery remains an acceptable method for delivering neonates.
From the Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, Texas.
Continuing medical education is available for this article at http://links.lww.com/AOG/A156.
Corresponding author: Edward R. Yeomans, MD, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, 3601 Fourth Street, STOP 8340, Lubbock, TX 79430-8340; e-mail: firstname.lastname@example.org.
Financial Disclosure The author did not report any potential conflicts of interest.