Safety and reliability of forceps delivery based on a 3-dimensional fetal head evaluation: a retrospective study

Abstract

Aim: To evaluate the maternal-neonatal complications of a forceps delivery (FD) by using trapezoidal-Station (t-St), a 3-dimensional assessment of fetal head descent.

Methods: This was a retrospective study of 1532 FDs conducted between 1985 and 2012. First, overall outcomes of FDs using t-St were analyzed between years. Second, for FDs from 2007 to 2012, a more detailed analysis of complications was drawn, making comparisons between normal deliveries (NDs) and FDs, and between t-St+2 and t-St+3/lower.

Results: Of the 1532 FD cases performed in 28 years, two cases (0.1%) failed. Comparison of ND and FD cases from 2007 to 2012 revealed no significant difference in incidence of 4th degree perineal laceration. No perinatal deaths or cerebral palsy were noted. Comparison of t-St+2 and t-St+3/lower revealed no significant differences in blood loss volume, umbilical cord arterial blood pH, incidence of 3rd/4th degree perineal lacerations (OR, 0.88; 95% CI, 0.35–2.23), or incidence of Apgar score<7 at 1 (OR, 1.93; 95% CI, 0.59–6.27) and 5 minutes (OR, 2.80; 95% CI, 0.25–31.59).

Conclusions: FDs using the 3-dimensional assessment were performed safely. The t-St may be an objective and precise assessment of fetal head descent, enabling safe management of FDs.