Changing trends of forceps delivery in Chang Gung Memorial Hospital.

Two hundred and fifty-five patients underwent forceps deliveries in Chang Gung Memorial Hospital from January 1, 1985 to June 30, 1990. There was neither maternal nor perinatal mortality related to this procedure during this period; and the perinatal outcome was good without sequela. In the past three years, cesarean section took the place of forceps delivery in some cases with acute fetal distress and malposition. As a result, maternal problems became the most common indication for forceps delivery during that period. Fourth degree laceration of the perineum was the major maternal complication, occurring in 22.4% of total forceps deliveries. Postpartum voiding problems continued to be another complication after forceps delivery, accounting for 7.0%. Either fourth degree laceration of the perineum or postpartum voiding difficulty could be prevented to a certain extent if the forceps were handled delicately in an experienced hand and there was early diagnosis with prompt management of voiding dysfunction.