干旱区生态环境知识资源中心(Arid): Kielland's rotational forceps delivery: A comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries

Arid

DOI	10.1016/j.ejogrb.2020.08.026
	Kielland's rotational forceps delivery: A comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries
	Giacchino, Tara; Karkia, Rebecca; Zhang, Weiyu; Beta, Jaroslaw; Ahmed, Hasib; Akolekar, Ranjit
通讯作者	Akolekar, R
来源期刊	EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
ISSN	0301-2115
EISSN	1872-7654
出版年	2020
卷号	254 页码:175-180
英文摘要	Objectives: The objective of our study was to derive accurate estimates of risks of maternal and neonatal complications associated with Kielland's rotational forceps delivery (KRFD) compared to rotational ventouse delivery (RVD) or 2nd stage caesarean section (CS). Methods: This was a retrospective cohort study undertaken at a large tertiary maternity and neonatal unit in the United Kingdom between January 2010 and June 2018. Pregnancies with fetal demise, major fetal defects, those lost to follow-up, those delivering by elective or emergency CS in the first stage of labour and non-rotational instrumental deliveries were excluded. The study population included singleton pregnancies delivering by Kielland's forceps, rotational ventouse, 2nd stage CS or spontaneous unassisted cephalic vaginal delivery; the latter forming the control group. The maternal outcomes examined included post-partum haemorrhage (PPH) and obstetric anal sphincter injury (OASIS). The neonatal outcomes included admission to neonatal intensive care unit (NICU), 5-minute Apgar scores <7, hypoxic ischaemic encephalopathy (HIE), jaundice, shoulder dystocia and birth trauma. Absolute risks with 95 confidence intervals (CI) were calculated in the study groups. Univariate and multivariate logistic regression analysis was carried out to estimate crude and adjusted odds ratio (OR) with 95 % CI. Results: The study population of 23,786 pregnancies included: 491 (2.1 %) requiring KRFD, 344 (1.4 %) requiring RVD, 840 (3.5 %) that had a 2nd stage CS and 22,111 (93.0 %) spontaneous cephalic vaginal deliveries. With regard to maternal adverse outcomes, in pregnancies that had a KRFD compared to RVD, there was no significant difference in the incidence of OASIS (p = 0.599) or PPH (p = 0.982). In contrast, the risk of PPH was significantly higher in those delivering by a 2nd stage CS compared to KRFD (27.5 % vs. 12.4 %; p < 0.0001). With regard to neonatal adverse outcomes, in those delivering by KRFD compared to RVD and 2nd stage CS, there was no significant difference in the incidence of admission to NICU (p = 0.912; p = 0.746, respectively), 5-minute Apgar score <7 (p = 0.335; p = 0.150, respectively), jaundice (p = 0.810; p = 0.332, respectively), mild shoulder dystocia (p = 0.077), severe shoulder dystocia (p = 0.603) or birth trauma (p = 0.265; p = 0.323, respectively). The risk of maternal composite adverse outcome was highest after 2nd stage CS (OR 7.68; 95 %CI: 6.52-9.04) and lowest after KRFD (OR 3.82; 95 %CI: 2.98-4.91). The risk of composite neonatal adverse outcome was higher in those delivering by RVD (OR 2.87; 95 %CI: 2.10-3.91), compared to KRFD (OR 2.23; 95 %CI: 1.67-2.97) or 2nd stage CS (OR 2.02; 95 %CI: 1.60-2.54). Conclusion: Our study demonstrates that KRFD is a safer management option when compared to RVD or 2nd stage CS for the management of persistent fetal malposition in labour. (C) 2020 Elsevier B.V. All rights reserved.
英文关键词	Kielland's forceps Rotational forceps delivery Fetal malposition Pregnancy outcomes
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000582243700031
WOS关键词	VAGINAL DELIVERY ; MALPOSITION ; SAFETY
WOS类目	Obstetrics & Gynecology ; Reproductive Biology
WOS研究方向	Obstetrics & Gynecology ; Reproductive Biology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/327111
作者单位	[Giacchino, Tara; Karkia, Rebecca; Ahmed, Hasib; Akolekar, Ranjit] Medway NHS Fdn Trust, Dept Obstet, Gillingham, Kent, England; [Zhang, Weiyu; Beta, Jaroslaw; Akolekar, Ranjit] Medway NHS Fdn Trust, Fetal Med Unit, Gillingham, Kent, England; [Giacchino, Tara; Ahmed, Hasib; Akolekar, Ranjit] Canterbury Christ Church Univ, Inst Med Sci, Canterbury, Kent, England; [Akolekar, Ranjit] Medway Innovat Inst, Gillingham, Kent, England
推荐引用方式 GB/T 7714	Giacchino, Tara,Karkia, Rebecca,Zhang, Weiyu,et al. Kielland's rotational forceps delivery: A comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries[J],2020,254:175-180.
APA	Giacchino, Tara,Karkia, Rebecca,Zhang, Weiyu,Beta, Jaroslaw,Ahmed, Hasib,&Akolekar, Ranjit.(2020).Kielland's rotational forceps delivery: A comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries.EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY,254,175-180.
MLA	Giacchino, Tara,et al."Kielland's rotational forceps delivery: A comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries".EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 254(2020):175-180.