Use and safety of Kielland's forceps in current obstetric practice.

OBJECTIVE

We sought to evaluate the use and safety of Kielland's rotational forceps for delivery in current obstetric practice at a tertiary care obstetric unit.

METHODS

Data were obtained pertaining to all such attempted deliveries from 1997 through 2011. The outcomes analyzed included maternal obstetric features, induction and duration of labor, use of analgesia, fetal position and station, birth weight, seniority of the obstetrician, success and failure rates, and associated maternal and neonatal morbidity.

RESULTS

There were 144 cases, of which 129 resulted in successful vaginal delivery (89.6%) and 15 were unsuccessful (10.4%). A senior obstetrician was present at all deliveries. The maternal morbidity was relatively low: third-degree or fourth-degree tear less than 1%, postpartum hemorrhage 12.4%, and urinary incontinence 7.8%. There were no cases of forceps-related neonatal trauma or hypoxic-ischemic encephalopathy.

CONCLUSION

Contrary to earlier reports, in these circumstances, use of Kielland's forceps is associated with a high successful delivery rate and apparently low maternal and neonatal morbidity.

LEVEL OF EVIDENCE: III.