Maternal and Neonatal Outcomes of Successful Kielland's Rotational Forceps Delivery

Sarah J. Stock, Katherine Josephs, Sarah Farquharson, Corinne Love, Sarah E. Cooper, Chris Kissack, Ranjit Akolekar, Jane E. Norman, Fiona C. Denison

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

OBJECTIVE: To estimate the rates of early neonatal and maternal complications in a consecutive series of successful Kielland's rotational forceps deliveries. METHODS: This was a retrospective cohort study of consecutive cases of successful rotational forceps deliveries performed in singleton pregnancies at 36 weeks of gestation or more in a tertiary referral center in Scotland, UK, from 2001 to 2008 (n=873). We also compared outcomes associated with successful rotational forceps deliveries in 2008 (n=150) with those of nonrotational forceps delivery (n=873), ventouse delivery (n=159), spontaneous vertex delivery (n=3,494), and emergency cesarean delivery (n=947). RESULTS: There was one stillbirth associated with a rotational forceps delivery. This was diagnosed before application of forceps. After rotational forceps deliveries, 58 of 872 (6.7%) of live-born neonates were admitted to the neonatal unit. Twenty-seven of 872 (3.1%) neonates had one or more complications that could be attributable to traumatic delivery and seven neonates (0.8%) had a diagnosis of neonatal encephalopathy. When compared with alternative methods of delivery over a single year, neonatal admission rates after delivery by rotational forceps deliveries (5 of 150 [3.3%]) were not significantly different from spontaneous vertex delivery (128 of 3,494 [3.7%; P=1.00]) or ventouse delivery (6 of 159 [3.8%; P=1.00]) and lower than emergency cesarean delivery (106 of 947 [11.2%; P=.002). Postpartum hemorrhage rates after rotational forceps deliveries (8 of 150 [5.3%; P=.008]) were lower than those associated with emergency cesarean delivery (142 of 947 [15.0%; P=.008]). CONCLUSION: Rates of short-term neonatal and maternal complications after successful rotational forceps deliveries are low. LEVEL OF EVIDENCE: II
Original languageEnglish
Pages (from-to)1032-1039
Number of pages8
JournalClinical obstetrics and gynecology
Volume121
Issue number5
DOIs
Publication statusPublished - 2013

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Keywords

  • Adult Cohort Studies Equipment Design Extraction, Obstetrical Female Humans Infant, Newborn Infant, Newborn, Diseases Obstetrical Forceps Postoperative Complications Pregnancy Pregnancy Outcome Retrospective Studies

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