Neonatal and maternal outcome in low-pelvic and midpelvic operative deliveries

A retrospective analysis of low-pelvic and midpelvic operative deliveries (according to the new definitions by the American College of Obstetricians and Gynecologists, 1989) matched with cesarean section deliveries of similar station was undertaken. In all vaginally delivered groups there was significantly decreased maternal morbidity, maternal hospital stay, and estimated blood loss. In the midpelvic deliveries, there was a significant increase in the frequency of neonatal resuscitation and an increase in base deficit for the umbilical artery. In both the midforceps and low-forceps groups, there was a significant increase of neonates with cord arterial pH less than 7.10, and an increase of base deficit, even when cases of fetal distress were eliminated. The midforceps group also had an increased rate of admission to the intensive care nursery and an increase in the risk of significant birth trauma. In considering a midforceps or midvacuum operative delivery, the potential associated risks to the neonate must be balanced against the benefits to the mother.