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 journalArticlepeer-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 - May 2013

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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