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Rotational forceps are an instrument that every labour ward specialist should be experienced with. Rotational forceps are the instrument par excellence for the occipito-posterior (OP) position. Most cases in which the fetus is found to be in a transverse position are attributable to a failure to rotate, generally as a result of an epidural block that has altered the muscular component of the rotational mechanism. Asynclitism is the oblique presentation of the fetal head in labour, and is important in the context of Kielland's forceps as it is corrected by the sliding lock on the instrument. The modern obstetrician should be able to assess a clinical situation and then decide which instrument is best suited to effect a safe birth. It is essential that Kielland's forceps are used only by obstetricians with the necessary training and experience.
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