Kielland’s rotational forceps delivery: A comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries

Vacuum extraction or caesarean section in the second stage of labour: A systematic review

“…Nolens et al 39 adjusted for strongest confounding factor per outcome and included: previous CS, birthweight, indication of delay, indication of fetal distress, impending uterine rupture, nulliparous and admission in second stage in their logistic regression. Bailit et al, 28 Giacchino et al, 31 and Hendler et al 34 did not specify for which confounding factors they adjusted. All studies but one scored the maximum score with regards to the selection of data, implying that it was known whether a woman gave birth by VE or SSCS, and that neither of the maternal or neonatal outcomes mentioned above in ‘data extraction’ were already present at the onset of VE or SSCS.…”

“…Fifteen articles were included in the final analysis, which provided outcomes of 32 823 vacuum-assisted births and 20 051 births by SSCS (Table 1). [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] During the critical appraisal, one study from Israel met the maximum score (Table 2). 41 Most studies (n = 12/15) did not describe the duration of follow-up for both women and neonates.…”

Maternal and neonatal complications following Kielland's rotational forceps delivery: A systematic review and meta‐analysis

“…Seventy-seven articles were retrieved in full text for detailed assessment and a further 64 studies that did not meet the selection criteria were excluded; thus, a total of 13 studies were included in the systematic review and metaanalysis. 2,[4][5][6][7]9,[14][15][16][17][18][19][20] The study selection process is shown in Figure 1 and the search strategy is outlined in Appendix S1.…”

“…The 13 studies included in the systematic review describe pregnancy outcomes following KRFD, with 11 studies reporting on both maternal and neonatal outcomes, 2,4–7,9,14,16,17,19,20 and with two studies reporting on maternal outcomes only 15,18 . Of these included studies, nine were retrospective cohort studies, 4,6,7,9,14–18 two were prospective cohort studies, 5,20 one was a matched case–control study, 2 and one was a case series 19 . With regards to the reporting of maternal adverse outcomes of PPH, there were variations in the definition of PPH between studies: two studies used a definition of estimated blood loss (EBL) > 500 ml; 4,5 three studies used EBL > 1 litre; 6,16,17 and one study used a cut‐off of 1.5 litres 20 .…”

“…Of these included studies, nine were retrospective cohort studies, 4,6,7,9,14–18 two were prospective cohort studies, 5,20 one was a matched case–control study, 2 and one was a case series 19 . With regards to the reporting of maternal adverse outcomes of PPH, there were variations in the definition of PPH between studies: two studies used a definition of estimated blood loss (EBL) > 500 ml; 4,5 three studies used EBL > 1 litre; 6,16,17 and one study used a cut‐off of 1.5 litres 20 . There was uniformity in the definition of OASIS, with all studies including either third‐ or fourth‐degree perineal damage as the definition of OASIS.…”