Mnemonic checklist: think FORCEPS before operative vaginal delivery.(Obstetrics)

MAUI, HAWAII -- The mnemonic FORCEPS can remind you of prerequisites for attempting an operative vaginal delivery, Dr. Michael Belfort said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law.

To make sure conditions are favorable for a vacuum or forceps extraction, run through the letters in FORCEPS, advised Dr. Belfort, director of maternal fetal medicine and professor of obstetrics and gynecology at the University of Utah, Salt Lake City.

F: The fetus is in a favorable head position, and you've done an assessment of fetal weight and status.

O: The patient has an open os, and the operating room is ready if needed. He defined an open os as a completely dilated cervix. "Even with the most basic outlet forceps, I always will say, 'Are we ready to go in the OR in case we need it?'" he said at the meeting, sponsored by Boston University and the Center for Human Genetics.

R: Membranes are ruptured, and the patient qualifies for operative vaginal delivery under the rule of threes, defined in a 1982 article: "In an OA [occiput anterior] presentation, if the sum of the number of fifths of the fetal head palpated above the pelvic inlet abdominally and the degree of molding of the fetal head palpated vaginally equals or ...