Neonatal and maternal outcomes of successful manual rotation to correct malposition of the fetal head; A retrospective and prospective observational study.

摘要: Objective To evaluate the neonatal and maternal outcomes associated with successful operative vaginal births assisted by manual rotation. Design Prospective retrospective observational study. Setting Delivery suite in a tertiary referral teaching hospital England. Population A cohort of 2,426 consecutive births, second stage labour, complicated malposition fetal head during 2006–2013. Methods Outcomes all successfully rotation followed direct traction instruments were compared other methods birth for labour (rotational ventouse, Kielland forceps caesarean section). Main outcome measures Associated (admission to special care baby unit, low cord pH, Apgar shoulder dystocia) (massive obstetric haemorrhage (blood loss >1500ml) anal sphincter injury). Results Births instruments, resulted 10% (36/346) babies being admitted Special Care Baby Unit, 4.9% (17/349) dystocia, 2% (7/349) massive 1.7% (6/349) injury, similar rotational births. Conclusions Adverse rotations comparable traditional There is an urgent need standardise practice (guidance, training) documentation instrumental deliveries that will enable assessment its efficacy absolute safety achieving birth.