Evaluation of midforceps delivery as an alternative.

The fetal intrapartum condition as well as maternal and immediate neonatal outcome of 274 consecutive midforceps rotations (head in transverse or posterior position and below + 1 station but without reaching the perineum) were compared with 106 cesarean sections done for arrest of progress for more than two hours and cervical dilatation of at lest 7 cm. It was found that there were more nulliparous among cesarean section patients, that their fetuses weighed near 400 gm more on the average, and that their time in labor was 200 minutes longer. On the other hand, the midforceps group had a higher incidence of spontaneous labor, conduction anesthesia, and intraprtum fetal distress (37%). There were no differences in fetal outcome, other than admission to NIC and/or NIM among C-section infants. This latter group had a higher postdelivery maternal complication rate (hemorrhage and infection), as well as longer than expected hospital stay. These findings are discussed. It appears that midforceps rotation, properly indicated and executed, offers a safe alternative to C-section for delivery of the infant.