[Is it legitimate today to perform large rotations with forceps?].

Many authors argue against the practice of large forceps rotations on the basis of a threefold increased neonatal risk compared to the use of forceps for anterior presentations. The experience of the Obstetric Clinic of Hôpital Edouard-Herriot in Lyon, of 81 major forceps rotations from a series of more than 10 000 births, is very similar to that of Chiswick in Manchester, based on 86 cases. In nearly one quarter of the neonates, there are discreet, transient neurological signs which disappear within one week and, did not leave any permanent sequelae. It would appear that large rotations should not be totally forbidden, but that their indications have to be carefully considered, especially in cases of foetal distress. An experienced obstetrician can perform these rotations: in experienced hands, they are often straightforward, but in cases of unexpected difficulty (1 case in 10 or 20) it should be immediately abandoned and a caesarian should be performed.