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Published on: June 6, 2020
Maternal and neonatal outcomes of successful Kielland's rotational forceps delivery
Sarah J Stock1, Katherine Josephs, Sarah Farquharson
1University of Edinburgh MRC Centre for Reproductive Health, Queen's Medical Royal, the Infirmary of Edinburgh, Little France, the Simpson Centre for Reproductive Health, and the Neonatal Unit, Simpson Centre for Reproductive Health, Edinburgh, and Medway National Health Service Foundation Trust, Gillingham, Kent, United Kingdom.
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.
