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.