Forceps delivery for non-rotational and rotational operative vaginal delivery

Black, Mairead; Murphy, Deirdre J

doi:10.1016/j.bpobgyn.2019.02.002

Cited by 14 publications

(8 citation statements)

References 42 publications

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“…Our findings are in accordance with recent data from literature, where the leading indications for forceps application were suggested to be fetal distress (identified by continuous cardiotocographic monitoring) (46.3%-78.1%), prolonged second stage of delivery (about 20% of cases) as well as the weak labor forces i.e. inadequate contractions (about 30% of cases) (10,15,19). Previous research suggested that avoiding induction of labor may reduce the risk for forceps application, although these findings have not been confirmed by recent studies (16).…”

Section: Discussionsupporting

confidence: 92%

“…Studies have shown that for a good delivery outcome, the most important thing is to maintain the procedure of forceps application the as short as possible. In contrast, the number of withdrawals as well as the total duration of delivery was not confirmed to significantly affect the perinatal outcome (15,16). In our study, there were no significant differences in total duration of delivery between the study and control group of patients.…”

Section: Discussioncontrasting

confidence: 80%

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Characteristics and Early Outcomes of Forceps Deliveries in a Tertiary Clinical Center

Cakic¹,

Likić-Ladjević

Vilendecic

et al. 2020

Central Eur J Paed

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Objective -The study aimed to investigate the characteristics of women and their children as well as the deliveries completed using forceps in one tertiary center. Material and Methods -The study included all women who had vaginal delivery during 2019. Women were classified according to use of the outlet forceps for delivery into the study and control group. We recorded maternal age and parity, duration of delivery, stimulation and epidural analgesia use, neonatal measures and Apgar score, maternal and neonatal complications after delivery. Results -Of the 3,570 vaginal births, forceps was applied 23 (0.64%) times. Most women were aged <35 years and were primiparous. The indication for forceps use in all cases was the delay in the expulsion phase. Forceps deliveries lasted on average 6.20+/-2.15 hours. In both groups, birth canal injuries were frequently registered (P=0.001), while uterine atony was rare (P=0.001). Postpartum anemia was more frequent after forceps application, however, not significantly. A similar number of children with and without neonatal complications was registered (P=0.140). Children born using forceps had lower Apgar scores than those from the control group (P=0.046) and spent longer time in the intensive care unit (P=0.038). There were no other significant differences in any of the tested parameters of mothers and children between the study and the control group. Conclusion -Use of forceps is remarkably rare in our setting. Children born using forceps have less favorable early perinatal outcomes, but few serious long-term complications. If applied skillfully and according to indications, forceps is safe for both mothers and children.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 80%

Characteristics and Early Outcomes of Forceps Deliveries in a Tertiary Clinical Center

Cakic¹,

Likić-Ladjević

Vilendecic

et al. 2020

Central Eur J Paed

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“…Butwick et al sphincter injury). [3][4][5][6] Therefore, identifying approaches that mitigate the likelihood of these morbidities in women who undergo operative vaginal delivery is of clinical importance.…”

Section: Instrumental Delivery and Neuraxial Analgesiamentioning

confidence: 99%

Association between Neuraxial Labor Analgesia and Neonatal Morbidity after Operative Vaginal Delivery

et al. 2020

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Background Up to 84% of women who undergo operative vaginal delivery receive neuraxial analgesia. However, little is known about the association between neuraxial analgesia and neonatal morbidity in women who undergo operative vaginal delivery. The authors hypothesized that neuraxial analgesia is associated with a reduced risk of neonatal morbidity among women undergoing operative vaginal delivery. Methods Using United States birth certificate data, the study identified women with singleton pregnancies who underwent operative vaginal (forceps- or vacuum-assisted delivery) in 2017. The authors examined the relationships between neuraxial labor analgesia and neonatal morbidity, the latter defined by any of the following: 5-min Apgar score less than 7, immediate assisted ventilation, assisted ventilation greater than 6 h, neonatal intensive care unit admission, neonatal transfer to a different facility within 24 h of delivery, and neonatal seizure or serious neurologic dysfunction. The authors accounted for sociodemographic and obstetric factors as potential confounders in their analysis. Results The study cohort comprised 106,845 women who underwent operative vaginal delivery, of whom 92,518 (86.6%) received neuraxial analgesia. The proportion of neonates with morbidity was higher in the neuraxial analgesia group than the nonneuraxial group (10,409 of 92,518 [11.3%] vs. 1,271 of 14,327 [8.9%], respectively; P < 0.001). The unadjusted relative risk was 1.27 (95% CI, 1.20 to 1.34; P < 0.001); after accounting for confounders using a multivariable model, the adjusted relative risk was 1.19 (95% CI, 1.12 to 1.26; P < 0.001). In a post hoc analysis, after excluding neonatal intensive care unit admission and neonatal transfer from the composite outcome, the effect of neuraxial analgesia on neonatal morbidity was not statistically significant (adjusted relative risk, 1.07; 95% CI, 1.00 to 1.16; P = 0.054). Conclusions In this population-based cross-sectional study, a neonatal benefit of neuraxial analgesia for operative vaginal delivery was not observed. Confounding by indication may explain the observed association between neuraxial analgesia and neonatal morbidity, however this dataset was not designed to evaluate such considerations. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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“…Vaginal forceps delivery, one of the surgical vaginal methods, could resolve cephalic dystocia effectively, for example, maternal exhaustion, maternal cardiac disease and a need to avoid pushing in the second stage of labor, prolonged second stage of labor, and nonreassuring fetal heart rate patterns in the second stage of labor [ 11 ]. Under these conditions, forceps delivery could be accomplished more safely and quickly than cesarean.…”

Section: Introductionmentioning

confidence: 99%

Clinical Effects of Form-Based Management of Forceps Delivery under Intelligent Medical Model

Xin

Wang

Lai

et al. 2021

Journal of Healthcare Engineering

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Background. Forceps delivery is one of the most important measures to facilitate vaginal delivery. It can reduce the rate of first cesarean delivery. Frustratingly, adverse maternal and neonatal outcomes associated with forceps delivery have been frequently reported in recent years. There are two major reasons: one is that the abilities of doctors and midwives in forceps delivery vary from hospital to hospital and the other one is lack of regulations in the management of forceps delivery. In order to improve the success rate of forceps delivery and reduce the incidence of maternal and neonatal complications, we applied form-based management to forceps delivery under an intelligent medical model. The aim of this work is to explore the clinical effects of form-based management of forceps delivery. Methods. Patients with forceps delivery in Maternal and Child Health Hospital Affiliated to Nanchang University were divided into two groups: form-based patients from January 1, 2019, to December 31, 2020, were selected as the study group, while traditional protocol patients from January 1, 2017, to December 31, 2018, were chosen as the control group. Then, we compared the maternal and neonatal outcomes of these two groups. Results. There were significant differences in the maternal and neonatal adverse outcomes such as rate of postpartum hemorrhage, degree of perineal laceration, and incidence of neonatal facial skin abrasions between the two groups, whereas differences in the incidence of asphyxia and intracranial hemorrhage were not significant. Conclusions. Form-based management could help us assess the security of forceps delivery comprehensively, as it could not only improve the success rate of the one-time forceps traction scheme but also reduce the incidence of maternal and neonatal adverse outcomes effectively.

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Forceps delivery for non-rotational and rotational operative vaginal delivery

Cited by 14 publications

References 42 publications

Characteristics and Early Outcomes of Forceps Deliveries in a Tertiary Clinical Center

Characteristics and Early Outcomes of Forceps Deliveries in a Tertiary Clinical Center

Association between Neuraxial Labor Analgesia and Neonatal Morbidity after Operative Vaginal Delivery

Clinical Effects of Form-Based Management of Forceps Delivery under Intelligent Medical Model

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