Rotational versus nonrotational forceps: Maternal and neonatal outcomes

OBJECTIVE: Our purpose was to evaluate maternal and neonatal morbidity asso ciated with rotations performed with Leff forceps in comparison with nonrot ational forceps deliveries. STUDY DESIGN: A review of 267 rotational and nonrotational forceps deliveri es from August 1996 through February 1998 was performed. Multiple maternal and neonatal outcome measures were compared and results were analyzed by ch i(2) With the Fisher exact test and the Student t test. RESULTS: One hundred sixty-three traditional low-forceps or outlet forceps deliveries were compared with 104 rotational forceps deliveries performed w ith Leff forceps. There were no significant differences between the 2 group s in maternal age, gestational age, gravidity, parity, total labor duration , birth weight, and Apgar scores. There were significantly lower rates of e pisiotomy, third- and fourth-degree lacerations, and sulcus lacerations in the rotation group, and the second stage of labor was also shorter. The neo natal intensive care unit admission rate was higher in the rotation group; however, none of the admissions were directly related to the mode of delive ry. CONCLUSION: Rotational deliveries performed with Leff forceps are associate d with less maternal morbidity and shorter second stage of labor than are d eliveries performed with traditional forceps. Leff forceps are a safe optio n for rotation of the persistent occipitoposterior fetal position.