The purpose of this communication is to draw attention to a consistent association between delivery with obstetrical forceps and serious injury to the forecoming head at birth.Traumatic intracranial hemorrhage was demonstrated at necropsy in 27 of 36,420 firstborn infants over a period of 17 years (1963 to 1979). All 27 were cephalic presentations to which forceps had been applied. Twelve were classified as more or less difficult, either because rotation was necessary or because delivery was effected face-to-pubis; 13 were classified as routine because traction only was needed: and two were classified as easy because Wrigley's forceps were used.The indication for forceps delivery was fetal distress in nine patients; maternal distress, usually after a long first stage, in six, and failure to advance in the second stage in nine patients. Prematurity was the sole indication in three patients. Forceps were not applied before full dilatation of the cervix in any instance.The smallest infant weighed 1130 g and the largest 4200 g. Six infants weighed 2500 g or less, nine weighed between 2500 and 3000g, seven weighed between 3000 and 3500 g, three weighed between 3500 and 4000 g, and two weighed more than 4000 g.
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