ABSTRACT
Instrumental vaginal delivery (IVD) is an essential part of the obstetrician’s armamentarium, and s/he must be competent and confident in both forceps and vacuum for non-rotational delivery, and at least one technique for rotational delivery. IVD is used to expedite delivery by shortening the second stage of labour. There are both maternal and fetal indications for IVD but it must be remembered that no indication is absolute, and each case must be assessed individually and the risks and benefits of continued pushing balanced against those of intervention. IVD can be conducted in the labour room or in theatre. On average, IVD undertaken in the delivery room takes around 15 minutes, whereas IVD following transfer to theatre takes around 30 minutes, thus the risks of delaying delivery by transferring to theatre must be balanced against the risks of a failed IVD in the room.
