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Neonatal morbidity in a low volume forceps practice.

Gabriel Levin1, Amihai Rottenstreich2,3, Simcha Yagel2,3

  • 1Department of Gynecologic Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|July 15, 2021
PubMed
Summary

Forceps extraction (FE) in low-volume settings shows a low rate of neonatal adverse outcomes. Factors like preterm delivery and low birth weight were associated with these outcomes.

Keywords:
Forceps extractionlow volumemorbidityneonatal outcometraumatic injury

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Clinical Practice Research

Background:

  • Forceps extraction (FE) use is declining, with underreporting of associated neonatal adverse outcomes.
  • Current obstetric practices, particularly in low-volume settings, require evaluation for neonatal outcomes following FE.

Purpose of the Study:

  • To assess the incidence of neonatal adverse outcomes in current obstetric practice at two university hospitals with low forceps extraction volume.
  • To identify factors associated with composite neonatal adverse outcomes (CNAO) in neonates delivered via FE.

Main Methods:

  • A multicenter retrospective study analyzing singleton pregnancies delivered by forceps extraction between 2011 and 2020.
  • Comparison of characteristics between deliveries with and without composite neonatal adverse outcomes (CNAO).

Main Results:

  • Out of 861 neonates delivered by FE, 15.2% experienced a CNAO.
  • Factors associated with CNAO included preterm delivery, low birth weight, and smaller head circumference.
  • Multivariate analysis indicated gestational age and maternal weight gain during pregnancy were negatively associated with CNAO.

Conclusions:

  • In low-volume forceps extraction settings, this delivery method is linked to a comparatively low rate of neonatal morbidity.
  • Maternal weight gain during pregnancy emerged as a key factor associated with neonatal outcomes in term deliveries.