Janisch H, Altmann P, Leodolter S, Reinold E
Z Geburtshilfe Perinatol. 1975 Oct;179(5):339-45.
The introduction of electronic monitoring techniques in delivery increasingly has lead to the use of vaginal surgery in delivery. Vacuum and forceps extraction, in our view, do not compete with each other. Years ago forceps extraction was decisively improved by introducing the axial traction forceps. However, we believe that this technique has not been given due attention and is not applied widely enough. In vacuum extraction and in forceps deliveries without axial traction considerable part of the force is exerted in the direction of the symphysis. When using the excentric handle forceps, it is necessary in addition to the traction and pressure components to include the lever action. This is a so-called couple of forces. The additional torque involved in the use of an axial traction forceps shifts the fetal head during extraction in the direction of the hollow of the sacrum. The force needed for this shift and the progression of the head is many times less than that required for conventional forceps extraction. This is due to the absence of the component directed at the symphysis which impedes delivery. The axial traction forceps may also be used in case of the infant's abnormal positioning of the head. In case of a transverse position of the fetal head, a special fastener on the forceps makes it possible to use an excentric handle on the traction hook of the Kielland forceps and thus render possible rotation of the fetal head from the transverse position. The extentric handle in forceps extraction is optimal in order to overcome increased mechanical resistance to delivery. Adjustment of the handles to all types of forceps being used today is possible. From the results mentioned it is clear that the use of the axial traction forceps constitutes a valuable contribution toward declining perinatal mortality rates.
分娩中电子监测技术的引入越来越多地导致了阴道手术在分娩中的应用。在我们看来，真空吸引和产钳助产并不相互竞争。多年前，通过引入轴向牵引产钳，产钳助产得到了决定性的改进。然而，我们认为这项技术没有得到应有的重视，应用也不够广泛。在真空吸引和无轴向牵引的产钳分娩中，相当一部分力量是朝着耻骨联合方向施加的。使用偏心柄产钳时，除了牵引和压力分量外，还需要考虑杠杆作用。这就是所谓的力偶。使用轴向牵引产钳时涉及的额外扭矩在牵引过程中将胎儿头部向骶骨凹陷方向移动。这种移动和头部前进所需的力量比传统产钳助产所需的力量小很多倍。这是因为没有朝着耻骨联合方向的阻碍分娩的分量。轴向牵引产钳也可用于婴儿头部异常定位的情况。在胎儿头部横位的情况下，产钳上的一个特殊固定装置使得可以在基兰德产钳的牵引钩上使用偏心柄，从而使胎儿头部从横位旋转成为可能。产钳助产中使用偏心柄对于克服增加的分娩机械阻力是最佳的。如今可以对所有类型的产钳进行手柄调整。从上述结果可以明显看出，轴向牵引产钳的使用对降低围产期死亡率做出了宝贵贡献。
