Trial and failed forceps in obstetrics.

Current literature dealing with trial and failed forceps is reviewed, and a representative case of each is presented. There is a place in modern obstetrics for trial forceps. "Failed forceps" is due to one or more of the following conditions: (1) cephalopelvic disproportion, (2) malposition of the head, (3) premature interference under conditions unfavourable for vaginal delivery, (4) incomplete dilatation of the cervix, and (5) constriction ring. A large caput succedaneum may occasion premature obstetrical interference. An adequate pelvic examination should be performed and/or lateral radiographs of the pelvis should be taken to prevent this mistake, i.e. attempted forceps extraction. There is no place in the management of failed forceps cases for version and extraction. It may be advisable to perform an elective Cesarean section following failed forceps, even with a dead fetus.