Operative vaginal delivery - An historical perspective.

This chapter will cover the evolution of forceps and vacuum-assisted delivery of the foetus in cephalic presentation. The options available before the development of obstetric forceps are briefly reviewed. The invention of the forceps in the early 17th century was followed by their evolution over four centuries with the introduction of the pelvic curve, axis-traction and rotational forceps. The phase of prophylactic forceps delivery will be discussed. The development of vacuum-assisted delivery has evolved over the past 150 years. However, in practical terms, the modern era of vacuum-assisted delivery began with Tage Malmström's vacuum extractor in the early 1950s. The evolution of the modern vacuum extractor with metal, soft and hard plastic cups will be reviewed.

The start of life: a history of obstetrics.

Obstetric intervention originally consisted of extraction of the baby, usually by the breech, to save the mother's life in obstructed labour. Forceps, introduced in the 17th century, were later refined by men-midwives like William Smellie. In Victorian times, Simpson championed chloroform anaesthesia, Lister pioneered antisepsis, and caesarean section was introduced. In 1935, however, Britain's maternal mortality rate was still around 400/100,000. It fell dramatically after antibiotics appeared and is now 11.4. In the 1960s ultrasound and electronic fetal monitoring became widely used. In 2000 the British caesarean section rate reached 20%. Worldwide, childbirth still causes 600,000 maternal deaths a year.

[Obstetrics--a gear in the machinery of history]. / Geburtshilfe--ein Rad im Räderwerk der Geschichte.

It was not Julius Caesar who was born by Caesarean section, as generally assumed, but Scipio Cornelius Africanus, who subdued Spain 100 years before Caesar's time. In chambers with walls of porphyrite, the Byzantine empresses used to give birth to the heirs to the throne. In England, the infertility of Queen Anne, who suffered from porphyria, led to the succession of the Protestant House of Hannover following the Catholic Stuarts. Christina of Sweden, called 'queen of baroque, rebel and scholar', was born in the 'caul'. At the age of 39 years, Johanna of Pfirt, married to Albrecht the Lame, secured the continuation of the Habsburg dynasty by giving birth to Rudolf the Founder. Maria Theresia, who had 16 children, was called 'mother-in-law of Europe'. She was delivered of her first child at the age of 19. The death of her sister Maria-Anna in childbed was one of the reasons why Gerard van Swieten was called to Vienna. Elisabeth of Württemberg, first wife of Franz I of Austria, died, not as a consequence of. but after a forceps operation carried out by Johann Lukas Boër. In England, Princess Charlotte, daughter of George IV, and her baby son died at the delivery; Sir Richard Croft, who had not used the forceps, committed suicide after this tragic incident. Being the next in succession, Victoria ascended the throne. The term 'narcose au chloroforme' (first used by James Young Simpson) was changed to 'narcose à la reine' after this method had been used at the birth of Victoria's eighth child by John Snow. It was Queen Victoria, who passed on haemophilia in European dynasties. When Marie Louise of Habsburg had her first child, Napoleon's son, the later Duke of Reichstadt, Antoine Dubois had to perform a turning of the transverse presentation and use the forceps on the head following after. The birth of Napoleon himself was a case of precipitate labour. Johann Klein, the successor of Boër, applied the forceps when Archduchess Sophie was delivered of her first child, the later Emperor Franz Joseph I of Austria, the first of the four 'salt princes'. The later Emperor Wilhelm II of Prussia was delivered by Eduard Arnold Martin the Elder, the obstetrician of Princess Victoria, the eldest daughter of Queen Victoria; the breech presentation became even more complicated by the raised arms of the child. Both latter monarchs had been 'asphyctic' after their birth. Johann Wolfgang von Goethe was also among those who were apparently dead after their birth.

[The inventors of the obstetric forceps and the obstetric lever]. / De uitvinders van de verlostang en de obstetrische hefboom.

A multiple lineage is proposed for the invention of the obstetric forceps. Having been conceived by a member of the Chamberlen family in fifteenth- or seventeenth-century England, the instrument seems to have been reinvented in Flanders by Jan Palfyn and in Holland by Rogier Roonhuyse. Later, Roonhuyse invented a more effective instrument for coping with the impacted head: the obstetric lever. Palfyn's "Iron Hands" inspired Dussé to produce the "French" forceps which bears his name.