[LATE EDEMATOUS KERATITIS CAUSED BY FORCEPS APPLICATION].
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The aim of this study was to determine the prevalence of, and the changes in, anorectal symptoms following different modes of vaginal delivery in primiparous women. Six hundred and seventeen questionnaires were distributed to primiparous women 3-4 years after delivery. The questionnaires were designed to obtain information regarding the development of anorectal symptoms, including the type of symptoms experienced, their severity and their impact on lifestyle. A total of 479 questionnaires were returned, representing a response rate of 77.6%. Women included in the study were divided into three groups on the basis of the mode of delivery (normal vaginal, vacuum extraction and forceps). Any episode of fecal incontinence was considered to be abnormal. Following delivery, de novo incontinence developed in 22%. There was no significant difference between the three modes of vaginal delivery in terms of the development of fecal incontinence (normal vaginal delivery 22%, vacuum extraction 20%, forceps delivery 26%). Furthermore, analysis of obstetric variables could not identify one significant independent risk factor for anorectal incontinence. The results of this study suggest that instrumental vaginal deliveries are as safe as a normal vaginal delivery in terms of the development of anorectal symptoms.
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Disadvantages of Kielland and Barton forceps are described. A trial of K.B.L. forceps was undertaken in transverse and posterior positions of the fetal head. It was concluded that these forceps are easier to apply than Kielland forceps. Rotation of the head is easier, and they are the equal of Kiellands as tractors, with the advantage of causing less marking of the fetal head than either Kielland or Barton forceps.
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