The role of forceps rotation in maternal and neonatal injury

Gary Hankins, T. Leicht, J. Van Hook, E. M. Uckan

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVE: Our purpose was to assess the impact of forceps rotation on maternal and neonatal injury. STUDY DESIGN: In this retrospective case- controlled study performed at the University of Texas Medical Branch at Galveston all forceps deliveries with a rotation of ≥90 degrees performed between July 1992 and September 1995 were identified (n = 113). For controls 167 forceps deliveries with rotations of ≤45 degrees were randomly selected. Control deliveries occurred during the same time period and were matched to within 2 weeks of gestational age as well as to nulliparous versus parous status. The majority of deliveries were low; however, some midforceps deliveries were also included. RESULTS: Forceps rotations of ≥90 degrees accounted for 0.8% of all deliveries. A major fetal injury, defined as a skull fracture, subdural hematoma, brachial plexus or a sixth or seventh cranial nerve injury, occurred in 10.2% of deliveries with rotations of ≤45 degrees and in 9.7% with rotations of ≥90 degrees. The only permanent injury was a brachial plexus palsy that occurred with a forceps rotation of 45 degrees. Rotations of ≥90 degrees were not associated with umbilical arterial acidemia below 7.0 or 7.1 compared with rotations of ≤45 degrees. Rotations of ≥90 degrees were associated with longer maternal hospital stays (P = .009). Neither lacerations of the birth canal, third- or fourth-degree episiotomies, or fall in the maternal hematocrit correlated with the degree of forceps rotation.

Original languageEnglish (US)
Pages (from-to)231-234
Number of pages4
JournalAmerican Journal of Obstetrics and Gynecology
Volume180
Issue number1 I
DOIs
StatePublished - 1999

Fingerprint

Surgical Instruments
Mothers
Wounds and Injuries
Brachial Plexus
Abducens Nerve Injury
Facial Nerve Injuries
Episiotomy
Skull Fractures
Umbilicus
Subdural Hematoma
Lacerations
Hematocrit
Paralysis
Gestational Age
Length of Stay
Parturition

Keywords

  • Forceps rotations ≥90 degrees
  • Occipitoposterior
  • Occipitotransverse

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

The role of forceps rotation in maternal and neonatal injury. / Hankins, Gary; Leicht, T.; Van Hook, J.; Uckan, E. M.

In: American Journal of Obstetrics and Gynecology, Vol. 180, No. 1 I, 1999, p. 231-234.

Research output: Contribution to journalArticle

Hankins, Gary ; Leicht, T. ; Van Hook, J. ; Uckan, E. M. / The role of forceps rotation in maternal and neonatal injury. In: American Journal of Obstetrics and Gynecology. 1999 ; Vol. 180, No. 1 I. pp. 231-234.
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