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Kjelland's forceps in the new millennium. Maternal and neonatal outcomes of attempted rotational forceps delivery
Author(s) -
ALSUHEL Raya,
GILL Simmerjyot,
ROBSON Stephen,
SHADBOLT Bruce
Publication year - 2009
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2009.01060.x
Subject(s) - forceps , medicine , forceps delivery , obstetrics , obstetrical forceps , caesarean section , singleton , adverse effect , pregnancy , gestation , pediatrics , vaginal delivery , surgery , genetics , biology
Background: The use of Kjelland's forceps is now uncommon, and published maternal and neonatal outcome data are from deliveries conducted more than a decade ago. The role of Kjelland's rotational delivery in the ‘modern era’ of high caesarean section rates is unclear. Aims: To compare the results of attempted Kjelland's forceps rotational delivery with other methods of instrumental delivery in a tertiary hospital. Methods: Retrospective review of all instrumental deliveries for singleton pregnancies 34 or more weeks gestation in a four‐year birth cohort, with reference to adverse maternal and neonatal outcomes. Results: The outcomes of 1067 attempted instrumental deliveries were analysed. Kjelland's forceps were successful in 95% of attempts. Kjelland's forceps deliveries had a rate of adverse maternal outcomes indistinguishable from non‐rotational ventouse, and lower than all other forms of instrumental delivery. Kjelland's forceps also had a lower rate of adverse neonatal outcomes than all other forms of instrumental delivery. Conclusions: Prudent use of Kjelland's forceps by experienced operators is associated with a very low rate of adverse maternal and neonatal outcomes. Training in this important obstetric skill should be reconsidered urgently, before it is lost forever.