Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Attempted Mode of Operative Delivery

Measuring maternal & neonatal outcomes

Decreased neonatal morbidity among neonates born to nulliparous women was observed in a trial of forceps delivery from a low station compared with cesarean delivery. This according to a study of 2,518 women carrying singleton fetuses at 37 weeks of gestation or greater. Researchers found:

• Among nulliparous patients, the maternal adverse composite was not significantly different between women who underwent attempted forceps (aOR=0.77), or vacuum (aOR=0.68) delivery compared with cesarean delivery.

• Compared with neonates delivered by cesarean, the neonatal adverse composite was significantly lower among neonates born to nulliparous women who underwent attempted forceps (aOR=0.44), but not among those who underwent vacuum delivery (aOR=0.68).

• Among parous women, the neonatal adverse composite was not significantly different after attempted forceps (aOR=0.28) or vacuum (aOR=1.03) compared with cesarean delivery.

Citation: Halscott TL, Reddy UM, Landy HJ, et al. Maternal and neonatal outcomes by attempted mode of operative delivery from a low station in the second stage of labor. [Published online ahead of print November 5, 2015]. Obstet Gynecol. doi: 10.1097/AOG.0000000000001156.