2020The Central European Journal of PaediatricsOpen access

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

Milica Cakić

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Abstract

O bjective - The study aimed to investigate the characteristics of women and their children as well as the deliveries completed us- ing forceps in one tertiary center. M aterial 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. R esults - 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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O bjective - The study aimed to investigate the characteristics of women and their children as well as the deliveries completed us- ing forceps in one tertiary center. M aterial 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. R esults - 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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Available abstract

O bjective - The study aimed to investigate the characteristics of women and their children as well as the deliveries completed us- ing forceps in one tertiary center. M aterial 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. R esults - 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.

Key concepts: Medicine, Forceps, Forceps delivery, Obstetrics, Uterine atony, Birth canal, Vaginal delivery, Tertiary care

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