Kielland forceps

Kielland Forceps

The Kielland Forceps are a type of obstetrical forceps designed for use in certain types of childbirth. Named after the Norwegian obstetrician Kristian Kielland, who introduced them in 1915, these forceps are distinguished by their lack of a pelvic curve and a sliding lock mechanism, which allows for greater flexibility in positioning relative to the baby's head.

Design and Features

Kielland Forceps are characterized by their flat, slender blades and a unique sliding lock, which differentiates them from other obstetrical forceps such as the Simpson's forceps or Tucker-McLane forceps. This design allows the forceps to be applied to the baby's head when it is in a variety of positions, making them particularly useful in cases where the baby's head is not perfectly aligned with the birth canal. The absence of a pelvic curve means that the forceps can be adjusted to accommodate different head positions without the need for multiple instruments.

Indications for Use

The primary indication for the use of Kielland Forceps is to assist in the delivery of a baby when complications arise that prevent the baby from being delivered through the birth canal without assistance. These complications may include:

• Prolonged second stage of labor
• Fetal distress
• Malposition of the baby's head, such as occiput posterior (OP) position or transverse lie
• Failure of the mother to effectively push the baby out due to exhaustion or epidural anesthesia

Procedure

The application of Kielland Forceps requires significant expertise and should only be performed by an experienced obstetrician. The procedure involves the careful placement of the forceps around the baby's head, taking care not to apply excessive pressure or cause injury. Once securely in place, the obstetrician uses the forceps to gently guide the baby through the birth canal, assisting the mother's pushing efforts.

Risks and Considerations

While Kielland Forceps can be a valuable tool in managing difficult deliveries, their use is not without risk. Potential complications include:

• Bruising or minor injuries to the baby's head
• More serious injuries such as facial nerve damage or skull fractures
• Increased risk of perineal tearing for the mother
• The need for a cesarean section if the forceps application is unsuccessful

Due to these risks, the decision to use Kielland Forceps must be made with careful consideration of the specific circumstances of the delivery and with informed consent from the mother.

Current Use

The use of Kielland Forceps has declined in recent years, with a preference for cesarean section in many of the situations where forceps might previously have been used. However, they remain an important option in certain cases, particularly where a cesarean section is not available or not the preferred choice for medical or personal reasons.