Rotational forceps: a retrospective study evaluating anatomical and functional consequences for the pelvic floor.
Avulsion
Kielland forceps
Rotational forceps
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
09
11
2020
accepted:
18
04
2021
pubmed:
16
5
2021
medline:
14
8
2021
entrez:
15
5
2021
Statut:
ppublish
Résumé
The use of Kielland's rotational forceps is considered to involve greater technical difficulty and may be associated with a higher rate of pelvic floor trauma. Our main objective was to evaluate the association between avulsion of the levator muscle and rotational and non-rotational forceps. This was an observational study carried out at a tertiary hospital that recruited singleton cephalic vaginally primiparous women with previous Kielland's forceps delivery between March 2012 and May 2017. Patients were retrieved from a local database, contacted consecutively and blinded to all clinical data. Power calculations determined a sample of n = 160 patients. All women underwent a urogynecological interview, clinical examination and 4D translabial ultrasound (TLUS). The 4D TLUS volumes were stored and analyzed offline by an experienced ultrasound examiner who was blinded to all clinical data. A total of 165 patients were available for analysis. Rotational forceps accounted for 27.3% (45 out of 165) of the study sample. Avulsion was present in 41.8% (69 out of 165) of all forceps deliveries. On multivariate analysis, rotational forceps was associated with avulsion, with an adjusted odds ratio (OR) of 2.57 (CI 95% 1.20-5.62, p = 0.016). Body mass index at the beginning of gestation was found to be a protective factor, with an adjusted OR of 0.918 (CI 95% 0.847-0.986, p = 0.025). Rotational forceps is associated with a higher avulsion rate than non-rotational forceps, with an adjusted OR of over 2.5. Obstetricians need to consider the potential long-term consequences of performing a rotational forceps for mothers.
Identifiants
pubmed: 33991219
doi: 10.1007/s00192-021-04814-x
pii: 10.1007/s00192-021-04814-x
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1857-1865Informations de copyright
© 2021. The International Urogynecological Association.
Références
Wegner EK, Bernstein IM. Operative vaginal delivery. In: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA, 2020.
Dunn PM. Dr Christian Kielland of Oslo (1871-1941) and his straight forceps. Arch Dis Child Fetal Neonatal Ed. 2004;89(5):F465–7.
doi: 10.1136/adc.2003.047993
Tempest N, Navaratnam K, Hapangama DK. Does advanced operative obstetrics still have a place in contemporary practice? Curr Opin Obstet Gynecol. 2015;27(2):115–2.
doi: 10.1097/GCO.0000000000000159
Dietz HP. Forceps: towards obsolescence or revival? Acta Obstet Gynecol Scand. 2015;94(4):347–51.
doi: 10.1111/aogs.12592
Chinnock M, Robson S. An anonymous survey of registrar training in the use of Kjelland's forceps in Australia. Aust N Z J Obstet Gynaecol. 2009;49(5):515–6.
doi: 10.1111/j.1479-828X.2009.01058.x
Tempest N, Hart A, Walkinshaw S, Hapangama DK. A re-evaluation of the role of rotational forceps: retrospective comparison of maternal and perinatal outcomes following different methods of birth for malposition in the second stage of labour. BJOG. 2013;120(10):1277–84.
doi: 10.1111/1471-0528.12199
Al Wattar BH, Al Wattar B, Gallos I, Pirie AM. Rotational vaginal delivery with Kielland's forceps: a systematic review and meta-analysis of effectiveness and safety outcomes. Curr Opin Obstet Gynecol. 2015;27(6):438–44.
doi: 10.1097/GCO.0000000000000221
Dietz HP, Simpson JM. Levator trauma is associated with pelvic organ prolapse. BJOG. 2008;115(8):979–84.
doi: 10.1111/j.1471-0528.2008.01751.x
Friedman T, Eslick GD, Dietz HP. Risk factors for prolapse recurrence: systematic review and meta-analysis. Int Urogynecol J. 2018;29(1):13–21.
doi: 10.1007/s00192-017-3475-4
Friedman T, Eslick GD, Dietz HP. Delivery mode and the risk of levator muscle avulsion: a meta-analysis. Int Urogynecol J. 2019;30(6):901–7.
doi: 10.1007/s00192-018-3827-8
Youssef A, Salsi G, Cataneo I, Pacella G, Azzarone C, Paganotto MC, et al. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion. Ultrasound Obstet Gynecol. 2019;53(1):95–100.
doi: 10.1002/uog.19085
Shek KL, Dietz HP. Can levator avulsion be predicted antenatally? Am J Obstet Gynecol. 2010;202(6):586.e1–6.
doi: 10.1016/j.ajog.2009.11.038
Valsky DV, Lipschuetz M, Bord A, Eldar I, Messing B, Hochner-Celnikier D, et al. Fetal head circumference and length of second stage of labor are risk factors for levator ani muscle injury, diagnosed by 3-dimensional transperineal ultrasound in primiparous women. Am J Obstet Gynecol. 2009;201(1):91.e1–7.
doi: 10.1016/j.ajog.2009.03.028
Dietz HP, Simpson JM. Does delayed child-bearing increase the risk of levator injury in labour? Aust N Z J Obstet Gynaecol. 2007;47(6):491–5.
doi: 10.1111/j.1479-828X.2007.00785.x
García Mejido JA, Aquise Pino A, Fernández Palacín A, de la Fuente VP, Ramos Vega Z, Sainz Bueno JA. The correlation between the type of forceps application and the rate of levator ani muscle avulsion: a prospective cohort study. Neurourol Urodyn. 2018;37(5):1731–6.
doi: 10.1002/nau.23500
Committee on Practice Bulletins—Obstetrics. Operative vaginal delivery. Practice bulletin no. 154. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2015;126:e56–65.
doi: 10.1097/AOG.0000000000001147
Sandvik H, Espuna M, Hunskaar S. Validity of the incontinence severity index: comparison with pad-weighing tests. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(5):520–4.
doi: 10.1007/s00192-005-0060-z
Minguez M, Garrigues V, Soria MJ, Andreu M, Mearin F, Clave P. Adaptation to Spanish language and validation of the fecal incontinence quality of life scale. Dis Colon Rectum. 2006;49(4):490–9.
doi: 10.1007/s10350-006-0514-5
Pons EM, Clota PM, Aguilón GM, Zardain PC, Alvarez RP. Questionnaire for evaluation of sexual function in women with genital prolapse and/or incontinence. Validation of the Spanish version of "pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12)". Actas Urol Esp. 2008;32(2):211–9.
doi: 10.1016/S0210-4806(08)73815-4
Madhu C, Swift S, Moloney-Geany S, Drake MJ. How to use the pelvic organ prolapse quantification (POP-Q) system? Neurourol Urodyn. 2018 Aug;37(S6):S39–43.
doi: 10.1002/nau.23740
Laycock J. Clinical evaluation of the pelvic floor. In: Schuessler B, editor. Pelvic floor re-education: principles and practice. London: Springer; 1994. p. 42–8.
Dietz HP, Shek KL. Validity and reproducibility of the digital detection of levator trauma. Int Urogynecol J. 2008;19:1097–101.
doi: 10.1007/s00192-008-0575-1
Dietz HP. Pelvic floor trauma in childbirth. Aust N Z J Obstet Gynaecol. 2013;53(3):220–30.
doi: 10.1111/ajo.12059
Orejuela F, Shek K, Dietz H. The time factor in the assessment of prolapse and levator ballooning. Int Urogynecol J. 2012;23:175–8.
doi: 10.1007/s00192-011-1533-x
Ornö AK, Dietz HP. Levator co-activation is a significant confounder of pelvic organ descent on Valsalva maneuver. Ultrasound Obstet Gynecol. 2007;30(3):346–50.
doi: 10.1002/uog.4082
Dietz HP, Bernardo MJ, Kirby A, Shek KL. Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound. Int Urogynecol J. 2011;22(6):699–704.
doi: 10.1007/s00192-010-1329-4
Dietz H, Abbu A, Shek K. The levator urethral gap measurement: a more objective means of determining levator avulsion? Ultrasound Obstet Gynecol. 2008;32:941–5.
doi: 10.1002/uog.6268
Dietz HP, Shek C, Clarke B. Biometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol. 2005;25(6):580–5.
doi: 10.1002/uog.1899
Dietz HP, Wong V, Shek KL. A simplified method for determining hiatal biometry. Aust N Z J Obstet Gynaecol. 2011;51(6):540–3.
doi: 10.1111/j.1479-828X.2011.01352.x
Majida M, Braekken IH, Umek W, Bø K, Saltyte Benth J, Ellstrøm EM. Interobserver repeatability of three- and four-dimensional transperineal ultrasound assessment of pelvic floor muscle anatomy and function. Ultrasound Obstet Gynecol. 2009;33(5):567–73.
doi: 10.1002/uog.6351
Dietz HP, Lekskulchai O. Ultrasound assessment of pelvic organ prolapse: the relationship between prolapse severity and symptoms. Ultrasound Obstet Gynecol. 2007;29(6):688–91.
doi: 10.1002/uog.4024
Shek KL, Dietz HP. What is abnormal uterine descent on translabial ultrasound? Int Urogynecol J. 2015;26(12):1783–7.
doi: 10.1007/s00192-015-2792-8
Naranjo-Ortiz C, Shek KL, Martin AJ, Dietz HP. What is normal bladder neck anatomy? Int Urogynecol J. 2016;27(6):945–50.
doi: 10.1007/s00192-015-2916-1
Parente MP, Jorge RM, Mascarenhas T, Fernandes AA, Martins JA. The influence of an occipito-posterior malposition on the biomechanical behavior of the pelvic floor. Eur J Obstet Gynecol Reprod Biol. 2009;144(Suppl 1):S166–9.
doi: 10.1016/j.ejogrb.2009.02.033
Dietz HP, Callaghan S. We need to treat pregnant women as adults. Aust N Z J Obstet Gynaecol. 2018;58(6):701–3.
doi: 10.1111/ajo.12885