John Lopamudra B, Nischintha S, Ghose Seetesh
Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.
J Nat Sci Biol Med. 2014 Jan;5(1):155-7. doi: 10.4103/0976-9668.127316.
The art of forceps delivery though existing for centuries has earned a disreputation due to the possibility of poor maternal and fetal outcome. However, its safe use can reduce the rising cesarean section rates in the present times. This study is to see the outcome of its use in a teaching hospital over a 2 year period.
In this retrospective observational study, 120 cases of forceps delivery were studied for maternal outcome such as injuries, postpartum hemorrhage, and fetal outcome such as Apgar score at birth, neonatal intensive care unit admissions, injury, and mortality.
The most common indication was fetal distress (47.5%). A total of 15 cases (12.5%) of maternal injuries occurred, with 2 uterine ruptures one of which was in a previous lower segment caesarean section case, 4 complete perineal tears and 9 minor cervical and vaginal lacerations. A total of 12 babies (10%) had poor Apgar scores who recovered after resuscitation and one out of them died, which was a case of multiple instrumentation.
Forceps is a reasonable option for the obstetrician to reduce the caesarean section rates; however, extreme caution, proper expertise and judicial use of this instrument are required to prevent undue risk to mother and fetus.
尽管产钳助产技术已经存在了几个世纪,但由于可能导致母婴不良结局,它一直声名不佳。然而,其安全使用可以降低当前不断上升的剖宫产率。本研究旨在观察其在一家教学医院两年期间的使用结果。
在这项回顾性观察研究中,对120例产钳助产病例进行了研究,观察产妇结局,如损伤、产后出血,以及胎儿结局,如出生时的阿氏评分、新生儿重症监护病房收治情况、损伤和死亡率。
最常见的指征是胎儿窘迫(47.5%)。共发生15例(12.5%)产妇损伤,其中2例子宫破裂,1例为既往低位剖宫产史,4例完全会阴裂伤,9例轻微宫颈和阴道裂伤。共有12名婴儿(10%)阿氏评分低,经复苏后恢复,其中1例死亡,为多次器械助产病例。
产钳是产科医生降低剖宫产率的合理选择;然而,需要极度谨慎、具备适当的专业知识并合理使用该器械,以防止对母亲和胎儿造成不必要的风险。