Forceps operations in perspective. I. Midforceps rotation operations

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Surgical Outcomes

Background:

• Midforceps rotation operations are a debated obstetric procedure.
• Assessing perinatal and maternal morbidity is crucial for evaluating surgical interventions.

Purpose of the Study:

• To evaluate the outcomes of midforceps rotation operations using standardized morbidity indices.
• To identify risk factors associated with suboptimal fetal and maternal outcomes.

Main Methods:

• Analysis of 458 consecutive midforceps rotation operations.
• Utilized a specially designed Perinatal Morbidity Index (PMI) and Maternal Morbidity Index (MMI).
• Identified and quantified risk factors impacting outcomes.

Main Results:

• Unfavorable fetal outcome occurred in 30.8% and unfavorable maternal outcome in 13.5% of cases.
• Twelve risk factors were associated with suboptimal results.
• Fetal outcomes worsened significantly with increased risk factors (11% with none vs. 47% with >=3).

Conclusions:

• Midforceps rotation operations carry substantial risks for both fetus and mother.
• Patients with significant risk factors should not undergo this procedure.
• Risk stratification is essential for patient selection in operative vaginal delivery.