| May 2008 · Vol. 20, No. 05 COMMENT & CONTROVERSY
Forceps are not the culprit. It’s the user
|
Fast Track
“The possibility for excess traction always exists, particularly when forceps are used by the less learned”
|
|
“Obstetric anal sphincter injury: 7 critical questions about care,” by Ranee Thakar, MD, MRCOG, and Abdul H. Sultan, MD, FRCOG (February)
In my opinion, the alleged greater likelihood of anal sphincter tear when forceps are used, compared with the vacuum extractor, does not arise from the instrument itself, but the way it is used—specifically, the injudicious application of traction. Such excess traction is a likely occurrence, particularly in the presence of unrecognized cephalopelvic disproportion, and may be the major risk factor for anal sphincter injury. In fact, because the amount of traction applied can only be measured subjectively, the possibility for excess traction always exists, particularly when forceps are used by the less learned.
|
