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Risk factors for forceps delivery in nulliparous patients
Chafika Mazouni1, Géraldine Porcu, Florence Bretelle
1Department of Gynecology and Obstetrics, Marseille Public Hospital System (APHM), France. chafika.mazouni@mail.ap-hm.fr
Acta Obstetricia Et Gynecologica Scandinavica
|March 24, 2006
Summary
Key risk factors for forceps delivery in first-time mothers include fetal head position, birth weight over 4000g, and epidural use. Maternal age over 35 and labor induction also increase the likelihood of instrumental delivery.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatal Research
Background:
- Instrumental vaginal delivery, including forceps, is common in nulliparous women.
- Identifying risk factors for forceps delivery is crucial for optimizing obstetric outcomes.
- Understanding these factors can inform clinical decision-making and patient counseling.
Purpose of the Study:
- To identify and analyze the significant risk factors associated with forceps delivery in nulliparous women.
- To differentiate between antenatal and intrapartum risk factors for instrumental vaginal birth.
Main Methods:
- A retrospective case-control study design was employed.
- Data were collected from 582 nulliparous women delivering vaginally (with or without instrumental assistance) at a tertiary maternity ward.
- Inclusion criteria included term gestation (>37 weeks), singleton, and cephalic presentation.
Main Results:
- Strongest risk factors identified: birth weight >4000g (OR: 6.5), occiput posterior fetal head position (OR: 5.8), and epidural analgesia (OR: 7.7).
- Other significant risk factors: maternal age >35 years (OR: 2.4), labor induction (OR: 2.1), prolonged first stage of labor (>420 min) (OR: 2.3), and prolonged second stage (OR: 1.6).
Conclusions:
- Maternal age over 35 and labor induction are identified as admission risk factors for forceps delivery.
- Intrapartum risk factors include epidural use, occiput posterior fetal head position, and birth weight exceeding 4000g, significantly increasing the likelihood of instrumental delivery in nulliparous women.