Cardozo L D, Gibb D M, Studd J W, Cooper D J
Br Med J (Clin Res Ed). 1983 Jul 30;287(6388):315-7. doi: 10.1136/bmj.287.6388.315.
To assess the risks associated with the use of Kielland's forceps 2708 consecutive deliveries were studied prospectively and the neonatal outcome related to the mode of delivery. Of the 1191 primigravidas, 279 (23.4%) underwent instrumental delivery, of whom 65 (5.5%) were delivered with Kielland's forceps. There was no difference in early neonatal outcome (as judged by Apgar scores, intubations, and admission to the special care baby unit) between these babies and those delivered normally or by non-rotational forceps, but a higher proportion of the 127 (10.7%) delivered by emergency caesarean section were compromised. Of the 1517 multigravid patients, only 57 (3.8%) underwent instrumental delivery, 15 (1.0%) by Kielland's forceps. Among these babies, also, the outcome was no worse than for those delivered normally, but the babies delivered by caesarean section showed a greatly increased incidence of low Apgar scores, intubations, and admission to the special care baby unit. There were no stillbirths or neonatal deaths among babies delivered by Kielland's forceps, nor were there any cases of severe birth trauma or of obvious neonatal morbidity.
为评估使用基兰德产钳相关的风险，对2708例连续分娩进行了前瞻性研究，并分析了与分娩方式相关的新生儿结局。在1191例初产妇中，279例（23.4%）接受了器械助产，其中65例（5.5%）使用基兰德产钳分娩。这些婴儿与正常分娩或使用非旋转产钳分娩的婴儿相比，早期新生儿结局（根据阿氏评分、插管情况以及入住特殊护理婴儿病房情况判断）并无差异，但127例（10.7%）接受急诊剖宫产的婴儿中，情况不佳的比例更高。在1517例经产妇中，只有57例（3.8%）接受了器械助产，其中15例（1.0%）使用基兰德产钳。在这些婴儿中，结局也不比正常分娩的婴儿差，但剖宫产分娩的婴儿阿氏评分低、需要插管以及入住特殊护理婴儿病房的发生率大幅增加。使用基兰德产钳分娩的婴儿中没有死产或新生儿死亡情况，也没有严重产伤或明显新生儿疾病的病例。
