US2034299A - Obstetrical forceps - Google Patents

Description

March 17, 193%. J B JACOBS OBSTETRICAL FORCEPS Filed April 26, 1935 2 Sheets-Sheet l March 17, 'J B. JACOBS OBSTETRICAL FORCEPS Filed April 26, 1955 2 Sheets-Sheet 2 Patented Mar.

UNITED STATES PATENT OFFICE 2,034,299 OBSTETRICAL FORCEPS Julian Bay Jacobs, East Falls Church, Va. Application April 26, 1935, Serial No. 18,446

8 Claims.

This invention relates to new and useful improvements in forceps such the practice of obstetrics.

clans have available for classical curved type (having as are employed in At present obstetritheir use, forceps of the blades curved in conformity with the pelvic tract) the Kielland forceps which can be used only by the most highly skilled practitioners,

and thirdly various forms of traction devices for use with both types of instruments to facilitate extraction of the head during a delivering operation.

intended to f acilitat The traction devices are e movement of the blades in a direction following the natural curvature of the pelvic tract.

However, traction devices have been found in the profession to be very unwieldy in use, and are only used in isolated cases,

some obstetricians,

their personal skill offsets tributes of such an The Kielland forceps blades substantially handles. In other and in no cases by when it is their belief that appliance in their work.

are of the type having the same plane as their classical on words, there is no curvature to the blades of this type of instrument. While the cephalic curve is present in the blades of the Kielland type, said curvature does not assist in any way in blade with the same classical curves, and for this reason the insertion of the facility as blades having the great care must be exercised in effecting the proper insertion of the to the uterus.

The conventional blade to prevent perforation or injury instrument with blades of the classical curve, and the Kielland forceps have merit in certain independent steps required incident to positioning 0 its occiput frontally Now as before being substantially quires considerable f the birth objects head with posed.

stated, the Kielland instrument straight in elongation, re-

skill to be exercised in inserting the blades thereof, and when the head of the birth object has been rotated to the proper position so that the occiput is at the front of the pelvis, the handles of the forceps are depending in only a slightly better position than when the classical type of forceps are employed and have become inverted as a result of this act of rotating the head. In this connection, it is the purpose of the Kielland type of removing the setting the same on forceps to eliminate the step blades and reinserting and rethe babys head, as must be done with the classical type of forceps to conform with the natural curvature of the vaginal tract when extraction is Therefore, it can taking place. be seen that the manipulaany beneficial attion of the straight Kielland instrument in the curved passageway of the pelvis has a certain degree of adversity which if not guarded carefully is apt to result in serious injury to the patient, while on the other hand the necessity 5 of removing the curved type forceps after properly positioning the babys head, frequently results in a slippage or shifting of the head in the uterus before the classical blades can be righted and reinserted, this putting the patient to 10 considerable discomfort and requiring the obstetrician to exert extreme care and diligence to re-locate and retrieve the head, which may be in an entirely different posture.

Consolidation of the various steps in the com- 5 plete instrument delivery operation, in one continuous transaction, without removal of the forceps from the birth objects head is the paramount object of the present invention.

Another important object of the invention is 20 to provide an obstetric instrument with means whereby instruments of the classical curvature type can be adjusted from inverted to righted position without disengaging the blades from the birth objects head.

Still another object of importance is to provide obstetrical forceps with adjusting means wherein the blades can be adjusted with respect to the handles thereof to afford an instrument having the well known classical curve, or to a 30 position extending on the same plane as the handle to permit use in accordance with the adaptability of the Kielland forceps, and furthermore permitting adjustment when the occiput is properly positioned, between the blades and 35 the handles, as when the curvature of the instrument is adverse to the curvature of the pelvic passageway, so as to restore the instrument to an inverse curvature conforming with the curvature of the said pelvic passageway. 40

A further object of the invention is to provide obstetrical forceps with blades having concavities on the inner sides thereof instead of fenestrations which frequently cause trouble in delivery because of insufficient contact surface, or else they 4 catch over the ischial spines and result in injury.

Still a further object of the invention is to afford an obstetrical instrument which will facilitate cases of occiput posterior and deep trans- 5o verse arrest.

These and various other important objects of the invention will become apparent to the reader of the following specification.

In the drawings .of grooves merge with bores compression type.

Figure 1 represents strument.

Figure 2 represents a side elevational view of the instrument.

Figure 3 represents a fragmentary inside elevational View of one of the blades with the shank thereof.

Figure 4 represents an end elevational view of the butt end of the instrument.

Figure 5 represents a. longitudinal sectional View through the forceps.

Figure 6 represents a transverse sectional view through the blades taken substantially on line 66 of Figure 5.

Figure 7 represents an inside elevational view one of the handles with the shank thereof. Figure 8 represents a cross sectional view taken substantially on line 88 .of Figure 1.

Figure 9 represents a perspective view of one of the pawls and the operating line therefor. Referring to the drawings wherein like numerals designate like parts, it can be seen that numerals 56 represent the obstetrical blades of the forcep, which are provided on their opposed sides with depressions or concavities 1. These depressions or concavities may simply be indentations in the blades extending longitudinally thereof, either in the form of a single pocket, or any arrangement of corrugations or rib formations.

The object here is to eliminate recesses through the blades which sometimes cause trouble in use.

Numerals 89 represent the handles for the blades 56 respectively. These handles 89 are provided with shanks Ill-l I, each of which is provided at its outer end with a threaded opening for receiving the corresponding screw l2 which pivotally connects the blades 5 or 6 thereto.

The pivotal end of each of the blades 5-6 is provided with a semi-circular curved portion I3 having a recess M at its mid-point and recesses l5-|6 at opposite sides of this recess I4, that is about forty-five degrees removed at each side of the recess 14. Beyond the recesses l3-l5 are shoulders I! against which the shanks l0-H can abut when the of the lateral notches I 5 or Hi.

It will be observed that the blade ends of the shanks I0,ll are slightly enlarged as at l9 and recessed as at 20 to receive the corresponding pawls 18.

As is clearly shown in Figures 1 and 5, each the shanks I0I| is grooved as at 2|, and said which lead in the corresponding hollow handle 8 or 9 and also into the corresponding pocket 20 of the shank. In each of these grooves 2| extends a flexible wire member 22' which at its blade end connects to the corresponding pawl l8 and at its handle end, extends into the cavity 23 of the handle where it attaches to a rod 24 on which an adjustable set screw retained collar 25 is carried.

Each of these rods 24 extends through the butt end of the corresponding handle 89 and between this butt end of each of the handles and the collar 25 on'the rod 24 is alspring 26 of the The spring 26 normally serves to maintain the pawls l8 urged into projected position into one of the notches l4, l5 or l6.

As is clearly shown in Figures 1 and 4, the handle 8 at its butt end has its rod 24 extending therethrough and at the outer end of this rod is attached a fork 21, which fork projects to the direction of the extending end of the complementary rod 24 and engages behind the head 28 a top plan view of the inpawls l8 are engaged in one thereof, so that when the fork 21 is pulled by its knob 29, bolt rods 2424 are pulled simultaneously, thus retracting both pawls l8 at the same time.

To cause both blades 56 to act coordinately, the blade 5 is provided with a pin 30 which loosely projects through an opening 3| in the shank end of the blade 6, as is very clearly shown in Figure 5.

The handle .9 is provided with a .pair of laterally extending guide members 32-32 which engage into the transverse depressions 33 on the handle 8. These members 32 serve as guides for the handle.

.In the use of this improved instrument, the blades 5-6 are adjusted either to the right or the left in Figure 2 to obtain a simulation of the classical curve found in most types of obstetrical forceps, with the exception of the Kielland type.

he two sections of the forceps are now dis- .connected and properly inserted to engage the head of the birth object, whether it be with the occiput posterior, or the occiput in deep transverse arrest, or in other positions, as the curved blade is most suitable in the majority of cases. When the blades have been engaged and the sections of the instrument locked together as shown in Figure 1, the head can be moved to proper position and when rotation of the head is necessary, a pull on the knob 29 will permit the handle to be adjusted with respect to the blades -56 so that they will be in substantial alinement as shown in Figure 2, in which position the instru ment can be used in the capacity of the Kielland forceps.

When the occiput of the birth object has been placed in the proper frontal position with respect to the pelvis and extraction is about to be performed, the handles 89 can .be moved .upwardly by pulling out on .theknob 29 so as to restore the instrument to theclassical curve type. These operations all take place without removing the blades of the forceps from the head of the birth object.

While the foregoing specification sets forth the invention in specific terms, it is to be understood that numerous changes in the shape, size and materials may be resorted to without departing from the spirit or scope of the invention as hereinafter claimed.

Having described the claimed as new is:

1. In combination, an obstetrical instrument comprising a pair of blades, a handle for .each of the blades and an adjustable connection between each of the blades and its corresponding handle, each of the adjustable .means consisting of a pawl and ratchet connection between each of the blades and its corresponding handle, each of the said handles being provided with control means for actuating the pawl of its corresponding blade.

2. In combination, an obstetrical instrument comprising a pair of blades, .a handle for each of the blades and an adjustable connection between each of the blades and its corresponding handle, each of the adjustable means consisting of a pawl and ratchet connection between each of the blades and its corresponding handle,

invention, what is spring means for projecting the said pawls and pull members extending to the butt end of the said handle, said pull members being provided with a single actuating of the handle.

3. In combination, an obstetrical instrument member at the butt ends' comprising a pair of blades, a handle for each of the blades and an adjustable connection between each of the blades and its corresponding handle, each of the adjustable means consisting of a pawl and ratchet connection between each of the blades and its corresponding handle, each of the said handles being provided with control means for actuating the pawl of its corresponding blade, said handles being hollow to receive the spring of the pawls.

4. In an obstetrical instrument including blades and handles therefor, an adjustable connection between the blades and the handle, said connection including means whereby the blades can be retained in substantial alinement with respect to the handles and further adjusted to extend obliquely in one direction or the other from said alined position to the classical divergence found in conventional classical curve type forceps.

5. In obstetrical forceps including blades and handles therefor, pin and recess adjusting means interposed between the blades and the handles thereof whereby the pin can be disposed into one of the recesses to hold the blades and handles adjusted with respect to each other to restore the instruments to a righted classical curvature when the instrument is actually in a substantially inverted position after certain steps in a delivery operation, without removing the blades from. operating position.

6. Forceps of the character described including blades and handles, adjustable joints between the blades and handles whereby the blades can be retained in substantially alined position with respect to the handles or swung to an oblique position, said joints including bolt and recess means for positively retaining said blades in alined or oblique position with respect to the handles.

7. Forceps of the character described including blades and handles, adjustable joints between the blades and handles whereby the blades can be retained in substantially alined position with respect to the handles or swung to an oblique position and positively retained in the latter position, and single operating means supported by the handles for controlling both joints simultaneously.

8. Forceps of the character described including blades and handles, adjustable joints between the blades and handles whereby the blades can be retained in substantially alined position with respect to the handles or swung to an oblique position and a detent for positively retaining the blades in the latter position, and means whereby the blades are caused to move together when the joints are broken.

J. BAY JACOBS.

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