FORCEPS AND VACUUM DELIVERY - A SURVEY OF NORTH-AMERICAN RESIDENCY PROGRAMS

Objective: To document resident instruction in operative vaginal deliv ery by forceps and vacuum. Methods: A survey was sent to all 291 obste trics-gynecology training programs in the United States and Canada. Re sults: The overall response rate was 72% (210 of 291). Most programs ( 60%) have an operative vaginal delivery rate of 10% or less. Nearly al l of the responding programs (199 of 209, 95%) teach operative vaginal delivery via the vacuum route; metallic cups are used in only 14% of centers. Forceps are the primary instrument in most programs (68%), bu t nearly one-third of responding centers use the vacuum method mom oft en than forceps, instruction in midpelvic operative vaginal delivery i s offered in 64% of the programs, with forceps being more common by ne arly a two-to-one ratio. Deep transverse arrest is handled initially b y forceps by half of the respondents, whereas 28 and 22% would proceed with cesarean or attempt a vacuum extraction, respectively. Conclusio n: Instruction in both types of operative vaginal delivery is found in most programs. The forceps are used more commonly, but vacuum is the preferred instrument in about one-third of training programs. instruct ion in midpelvic delivery is offered in 64% of programs, but we noted a declining trend.