Teaching the Laufe-Piper forceps technique at cesarean delivery

OBJECTIVE: To present a method of teaching forceps technique during cesarea n delivery of breech-presenting infants using Laufe-Piper forceps and to ev aluate its usefulness. STUDY DESIGN: For several years, residents at the University of Texas Medic al Branch, Galveston, have learned and practiced Piper forceps technique du ring cesarean delivery. To assess their experience with this method, we mai led questionnaires to third- and fourth year residents and recent graduates of the Galveston program. The same surveys were mailed to a control group of residents and recent graduates of two other programs where this teaching exercise is not practiced routinely. RESULTS: Responses were received from 32 (74%) study subjects and 63 (71%) controls. Demographic characteristics and experience with vaginal breech de livery were similar between the two groups. Respondents from the Galveston program noted greater annual use of forceps for vaginal delivery of cephali c-presenting infants (P = .012). They also rated themselves as move comfort able (P = .023) and more skilled (P = .006) with Piper forceps than control s. Of 53 respondents who had had previous experience with this teaching met hod, 47 noted that it provided a great or moderate educational benefit, and 36 strongly or moderately believed it gave them move confidence in using P iper forceps during vaginal breech delivery. Using multiple regression anal ysis, sex, overall level of experience, Piper forceps experience during vag inal delivery and overall forceps use were stronger determinants of self-ra ted com fort and skill than was experience with Laufe-Piper forceps during cesarean. CONCLUSION: Laufe-Piper forceps can be used for cesarean delivery of breech -presenting infants. This practice promotes confidence and skill for their use at vaginal delivery.