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PubMed1989

The effects of forceps delivery on facial growth.

Postnatal growth of the face is a composite function of genetic and environmental factors. A sudden traumatic insult due to the use of forceps at birth could have long-term effects which could detrimentally influence growth and development. This study examines the development of the skeletal and dental components of forceps vs. non-forceps-delivered patients. The association between delivery methods as related to TMJ problems, bruxism, posterior crossbites, and molar arch width differences was evaluated in 16 forceps-delivered and 29 naturally delivered patients. Results showed no statistically significant difference between delivery method and TMJ problems, posterior crossbites, bruxism, or molar arch width. It was noted that the non-forceps group had a higher incidence of posterior crossbite and narrower molar arch width. The forceps-delivered group had a higher percentage of bruxism and TMJ pain and/or noise. It was also noted that the small sample size may have influenced the statistical relationships.

Adolescent↗
PubMed1980

Intrauterine rupture of the umbilical cord during delivery.

Two cases of bleeding from ruptured umbilical vein during delivery are reported. In one case the rupture was spontaneous, leading to fetal distress. In the second case the rupture was probably iatrogenic, and was caused by forceps delivery. Bleeding from ruptured umbilical vessel should be considered when a combination of variable decelerations during fetal heart rate monitoring, blood-stained amniotic fluid and fetal distress are detected during delivery.

Adult↗
PubMed1984

Long-term effects of labor and delivery on offspring: a matched-pair analysis.

An investigation was undertaken in an effort to learn whether the type of delivery or the pattern of labor progression has any lasting effect on the infant. Paired-data design was chosen to ensure that the comparisons between homogeneous groups would be valid. Our objective was to reduce potential bias based on unequal distribution of patient characteristics that might be more or less commonly associated with abnormal labors or with difficult deliveries. Seven-year intelligence quotient data for matched pairs of cases showed significant long-range adverse impact from midforceps operations but not from low-forceps procedures. Comparable paired-data analysis for the effect of labor disorder on the infant verified a similar deleterious influence from both arrest and protraction patterns.

Child↗
PubMed1985

The midforceps: maternal and neonatal outcomes.

A retrospective review of midforceps deliveries occurring between 1976 and 1982 at a county teaching hospital is presented. Midforceps deliveries were performed in 0.8% of deliveries (176 of 21,414) during this period, a rate reflecting the general admonition against potentially traumatic injury to the infant. Under these conditions, midforceps deliveries were associated with active and second-stage labor abnormalities, abnormal fetal heart rate patterns, maternal perineal lacerations, low 1-minute Apgar scores, and neonatal cephalohematomas more frequently than were deliveries of the remainder of the patients. Epidural anesthesia was significantly associated with midforceps deliveries. Midforceps patients were matched to similar groups who were delivered by cesarean section or low forceps or who had spontaneous births. The findings do not document an increase in short-term neonatal morbidity in the midforceps group under the conditions described.

Birth Injuries↗
PubMed2001

[Traumatic injuries of newborns after forceps delivery at the Abass Hospital Center Maternity].

The authors report the results of a retrospective study on the effect of traumatic injuries observed among newborns from forceps deliveries in the maternity ward of Abass Ndao hospital between January 1st, 1995 and December 31, 1996. Forceps deliveries represent 5.89 for 1000 of total deliveries and 47 for 1000 of nursery admissions. Traumatic injuries are found in 44.77 % of the newborn by forceps deliveries. They are dominated by the hematoma of scalp in 23 cases and facial nerve injuries in 6 cases. The were about 76.66 percent of primipare among which 30 percent were adolescents. Maternal age, parity, gravity as well as birth weight for forceps deliveries were not significantly different from those without any injuries (p < 0.05). However, traumatic injuries of the newborn were more frequent when the forceps were performed by medical resident. The neonatal mortality is 10.44%. We recommend the teaching of the technique for an improvement of technical competence.

Adolescent↗
PubMed2005

Randomised controlled trial of community debriefing following operative delivery.

OBJECTIVE: The aim of this study was to determine if two debriefing sessions following an operative delivery could reduce a woman's fear of future childbirth. DESIGN: Prospective randomised controlled trial (RCT) with two arms comparing debriefing, aimed to reduce fear of future childbirth, with standard care after birth. SETTING: District General Hospital with 2500 deliveries per year. SAMPLE: Three hundred and nineteen mothers who delivered a first child by operative delivery (i.e. forceps, vacuum or emergency caesarean section). The study took place at Huddersfield Royal Infirmary, from January 2002 to July 2003. METHODS: Debriefing by community midwives specifically trained in postpartum debriefing at 10 days and 10 weeks. MAIN OUTCOME MEASURE: Fear of childbirth was assessed using the Wijma Delivery Expectancy Scale (WDEQ). WDEQ scores were measured 10 days, 10 weeks and 20 weeks following delivery. RESULTS: Fear of childbirth as measured by the WDEQ was lower throughout the study for the debriefing group. However, it never reached statistical significance in the short term [10 days debriefing = 94.5, control = 97.5 (P= 0.295), 10 weeks debriefing = 92.0, control = 97.9 (P= 0.076), 20 weeks debriefing = 90.9, control = 97.4 (P= 0.057)]. CONCLUSION: This study shows in the short term there was no significant difference in the WDEQ fear of childbirth scores. The debriefing group were showing a tendency for lower scores. Long term follow up of these cases may be more relevant.

Adult↗
PubMed1982

Analgesia and satisfaction in childbirth (the Queen Charlotte's 1000 Mother Survey).

Maternal satisfaction with the experience of childbirth was investigated in 1000 women having a vaginal delivery of a live child. Effective pain relief did not ensure a satisfactory birth experience. Epidural block produced the most effective analgesia but there were more dissatisfied women among the epidural patients than among those who did not receive this analgesia (p less than 0.05). Bad experience scores were evaluated one year later and were clearly related to a forceps delivery and long labour, both of which were more common in the epidural group. The desirability of an "epidural on demand" service should be tested against an "epidural when necessary" service.

Analgesia↗
PubMedDate not supplied

Relationship of difficult forceps delivery to dental arches and occlusion.

This study examined the relationship between the extensive use of forceps procedures during delivery and later occlusal characteristics. The work uses data collected in National Collaborative Perinatal Research Project (USA), in which more than 60,000 pregnancies and the children's health were followed by regular medical tests and examinations. Of these, a subsample of 2,074 children participated in dental examinations, including the production of dental casts with wax bites to register occlusion. A total of 84 children, 55 boys and 29 girls, were coded as having undergone difficult or very difficult forceps deliveries. A control group was matched by age, sex, race, and site of dental examination. The results show a significant increase in asymmetric molar occlusion (P < 0.005) and canine relations (P < 0.001) in the study group. The sagittal length of the mandibular arch was increased in the difficult forceps delivery group (P < 0.01). In conclusion, difficult forceps procedures are associated with a later asymmetric occlusion.

Birth Injuries↗
PubMed1999

Rotational versus nonrotational forceps: maternal and neonatal outcomes.

OBJECTIVE: Our purpose was to evaluate maternal and neonatal morbidity associated with rotations performed with Leff forceps in comparison with nonrotational forceps deliveries. STUDY DESIGN: A review of 267 rotational and nonrotational forceps deliveries from August 1996 through February 1998 was performed. Multiple maternal and neonatal outcome measures were compared and results were analyzed by chi(2) with the Fisher exact test and the Student t test. RESULTS: One hundred sixty-three traditional low-forceps or outlet forceps deliveries were compared with 104 rotational forceps deliveries performed with Leff forceps. There were no significant differences between the 2 groups in maternal age, gestational age, gravidity, parity, total labor duration, birth weight, and Apgar scores. There were significantly lower rates of episiotomy, third- and fourth-degree lacerations, and sulcus lacerations in the rotation group, and the second stage of labor was also shorter. The neonatal intensive care unit admission rate was higher in the rotation group; however, none of the admissions were directly related to the mode of delivery. CONCLUSION: Rotational deliveries performed with Leff forceps are associated with less maternal morbidity and shorter second stage of labor than are deliveries performed with traditional forceps. Leff forceps are a safe option for rotation of the persistent occipitoposterior fetal position.

Adult↗
PubMed1992

Forceps delivery as a risk factor in epilepsy: some further observations.

A total of 381 children born with forceps delivery and 372 with normal delivery were followed up for 4-7 years. More children in the forceps group developed seizures than in the normal group, i.e. 22:10. This was statistically significant (P < 0.05). There was no neurological deficit in any child who had seizures. Both partial and generalized seizures were seen but partial seizures were more frequent.

Child, Preschool↗
PubMed1989

[Interlocking of twins].

We report about a very rare case of locked twins in cephalic presentations. A difficult forceps was necessary. In spite of cleidotomy and pushing the other twin out of the pelvis the fetus was in a deep distress and the resuscitation was unsuccessful. The second twin followed spontaneously, alive and well.

Adult↗
PubMed1997

A preterm infant with upper cervical spinal cord injury, following delivery with Kielland's forceps.

A report is presented of a male infant who was born at 34 weeks' gestation, following rotation and delivery using Kielland's forceps. The initial diagnosis of hypoxic ischaemic encephalopathy delayed recognition of an upper cervical spinal and cord injury, which was subsequently confirmed by magnetic resonance imaging. The infant never developed spontaneous respiration and died following withdrawal of intensive care at 21 days of age.

Adult↗
PubMed2003

[Epidural analgesia during labour with a singleton alive fetus at term].

OBJECTIVE: Whether epidural analgesia (e.a.) have influence on the way of delivery, indications to cesarean section (c.s.) and neonatal outcome. MATERIAL AND METHODS: We have analysed 8784 deliveries. We excluded women with plural pregnancy, pre-term parturitions, elective c.s., still births. Finally we studied 339 parturitions with e.a. versus 6868 the others and theirs newborns. RESULTS: More frequent c.s. was in women with e.a. (18.6% vs 7.9%; p < 0.001) or forceps (f.d.) (7.7% vs 3.5%; p < 0.005). Among those with e.a. the most frequent indications to c.s. were labour with no progression (23.4% vs 4.0%; p < 0.001) and the others as hypoxia fetus (68.7% vs 82.6%; p < 0.01). The lost of blood with oblique to transfusion was more frequent at f.d. at comparison to c.s. and spontaneous delivery (26.9% vs 3.2% and 6.8%; p < 0.001). The condition of neonates at 1 min. according Apgar score was the worse after f.d. in comparison to spontaneous delivery (7.38 +/- 2.22 vs 8.79 +/- 1.41 points; p < 0.005) and after c.s. (7.38 +/- 2.22 vs 8.55 points; p < 0.05). In comparison the state at 5 min. was the similar after f.d. (9.11 +/- 1.24 vs 9.53 +/- 0.81 points; p = 0.05) and (9.11 +/- 1.24 vs 9.48 +/- 0.83 points; p = 0.09). CONCLUSIONS: Women with epidural analgesia more frequent were ending the delivery by cesarean section or forceps. The forceps delivery was related with worse neonatal outcome at first minutes of live, and bigger lost of blood during labour. Epidural analgesia predisposed to cesarean section delivery caused of partus without progress and relatively deminished caused by fetus hypoxia.

Adult↗
PubMed1984

Neonatal acidosis and method of delivery.

Seven hundred and four women who had a forceps termination (177 elective, 293 indicated low, and 234 indicated midforceps) of labor over 24 months were compared with 303 spontaneous and 111 cesarean deliveries over the same time period. There was no significant difference between indicated low or midforceps either for fetal distress or arrest of descent with regard to fetal acidosis (pH less than 7.20), one- or five-minute Apgar scores less than 7, fetal trauma, or neurologic deficit at discharge. Fourteen percent of indicated forceps for arrest of descent had neonatal acidosis, versus 8% of cesarean sections for cephalopelvic disproportion (P = NS), and 23% of indicated forceps for fetal distress had acidosis, versus 33% of cesarean sections (P = not significant). There was no significant difference either in the incidence of acidosis or in low Apgar scores in neonates delivered by elective low forceps compared with those born by spontaneous vaginal delivery. The only significant differences in midforceps versus low forceps were between maternal pre- and postdelivery hematocrits (P less than .0001) and vaginal lacerations (P less than .0001). The authors' data support the continued usage of indicated low and selected midforceps operations.

Acidosis↗
PubMed2006

Risk factors for forceps delivery in nulliparous patients.

OBJECTIVE: To identify risk factors for forceps delivery during first pregnancy. MATERIALS AND METHODS: A retrospective case-control study was carried out in a tertiary maternity ward between January 2001 and December 2003. A total of 582 nulliparous women, with full-term (>37 weeks gestation), singleton, cephalic pregnancies, who delivered by the vaginal route with or without instrumental assistance were evaluated. RESULTS: The strongest risk factors for forceps delivery were birth weight greater than 4000 g (OR: 6.5; 95% CI: 1.6, 26.9), the occiput posterior position of the fetal head (OR: 5.8; 95% CI: 2.5, 13.8), and epidural analgesia (OR: 7.7; 95% CI: 4.1, 14.7). Other significant risk factors for forceps delivery were age over 35 years (OR: 2.4; 95% CI: 1.1, 5.1), induction of labor (OR: 2.1; 95% CI: 1.4, 3.1), first stage of labor longer than 420 min (OR: 2.3, 95% CI: 1.3,4.2), and a prolonged second stage of labor (OR: 1.6, 95% CI: 1.1, 2.4). CONCLUSION: Age over 35 years and induction of labor are risk factors for forceps delivery at admission. Epidural use, fetal head in occiput posterior position, and birth weight >4000 g are strong intrapartum risk factors for instrumental delivery in nulliparous women.

Adult↗
PubMed2005

Vesicouterine fistula as a complication of forceps delivery: a case report.

We report a case of vesicouterine fistula as a complication of forceps delivery revealed by urinary incontinence in a 68-year-old woman. Diagnosis was confirmed by examination and cystography. The treatment was a transperitoneal excision of the fistula. The literature is briefly reviewed and the treatment options are discussed.

Aged↗