Allison Bryant, MD, MPH reviewing Deering S. Obstet Gynecol 2016 Sep. Gossett DR et al. Obstet Gynecol 2016 Sep. Dildy GA et al. Obstet Gynecol 2016 Sep.

Can we rescue this dying art?

Forceps have long held an important place in the obstetrician's toolbox for delivery during the second stage of labor in the face of fetal or maternal concerns. However, the number of forceps deliveries in the U.S. has declined exponentially in recent decades, and resident training in the skill is near nonexistent in many programs. Editorialists have likened the procedure to “a species on the brink of extinction.” Now, investigators at an academic institution with a relatively high prevalence of forceps deliveries have developed a strategy for its salvage: With input from local experts, they designed a training curriculum that included didactic preparation plus hands-on training with a high-fidelity simulation model.

All residents completed the training over a 2-year period. In a retrospective cohort study, outcomes of 3859 forceps-assisted deliveries performed with resident providers throughout 7 years (before and after implementation of the program) were examined. Odds of severe perineal laceration were reduced by 23% if the resident at delivery had participated in the training program (adjusted odds ratio, 0.77; model adjusted for other factors associated with severe laceration).

CITATION(S):

Deering S.Forceps, simulation, and social media. Obstet Gynecol 2016 Sep; 128:425. 

Gossett DR et al. Simulation training for forceps-assisted vaginal delivery and rates of maternal perineal trauma. Obstet Gynecol 2016 Sep; 128:429.

Dildy GA et al. Obstetric forceps: A species on the brink of extinction. Obstet Gynecol 2016 Sep; 128:436.

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