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Maternal and neonatal outcomes of successful Kielland's rotational forceps delivery.

OBJECTIVE: To estimate the rates of early neonatal and maternal complications in a consecutive series of successful Kielland’s rotational forceps deliveries. METHODS: This was a retrospective cohort study of consecutive cases of successful rotational forceps deliveries performed in singleton pregnancies at 36 weeks of gestation or more in a tertiary referral center in Scotland, UK, from 2001 to 2008 (n 5 873). We also compared outcomes associated with successful rotational forceps deliveries in 2008 (n 5 150) with those of nonrotational forceps delivery (n 5 873), ventouse delivery (n 5 159), spontaneous vertex delivery (n 5 3,494), and emergency cesarean delivery (n 5 947). RESULTS: There was one stillbirth associated with a rotational forceps delivery. This was diagnosed before application of forceps. After rotational forceps deliveries, 58 of 872 (6.7%) of live-born neonates were admitted to the neonatal unit. Twenty-seven of 872 (3.1%) neonates had one or more complications that could be attribut-able to traumatic delivery and seven neonates (0.8%) had a diagnosis of neonatal encephalopathy. When compared with alternative methods of delivery over a single year, neonatal admission rates after delivery by rotational forceps deliveries (5 of 150 [3.3%]) were not significantly different from spontaneous vertex delivery (128 of 3,494 [3.7%; P 5 1.00]) or ventouse delivery (6 of 159 [3.8%; P 5 1.00]) and lower than emergency cesarean delivery (106 of 947 [11.2%; P 5 .002). Postpartum hemorrhage rates after rotational forceps deliveries hypertension, diabetes, cardiac condition, or other (poor obstetric history, obstetric cholestasis, antepartum hemorrhage).