Traumatic Intracranial Haemorrhage in Firstborn Infants and Delivery with Obstetric Forceps

Abstract

Exclusive of breech presentation, traumatic intracranial haemorrhage was demonstrated at necropsy on 27 occasions in 36 420 consecutive firstborn infants. All 27 were forceps deliveries, The main conclusion is that serious injury to the forecoming head at birth is almost invariably a direct effect of forceps. The relevance of this conclusion to some aspects of contemporary obstetric practice is discussed briefly.

Kielland’s forceps: does it increase the risk of anal sphincter injuries? An observational study

“…Concerns related to the use of Kielland's forceps are historically attributed to observational studies reporting adverse outcomes to the mother and fetus [12,13]. However, there is no definitive evidence that the use of Kielland's forceps adversely affects the baby's long-term development [14].…”

Unexplained Intracranial Haemorrhage in Utero: The Battered Fetus?

“…Major intracranial haemorrhage is an uncommon finding a t postmortems on stillborn infants. Subdural haemorrhages due to obstetric trauma are now infrequent (1). Minor subarachnoid haemorrhages may be found in cases with a history or other evidence of intrapartum asphyxia and, rarely, immature stillborn infants may have small intraventricular and periventricular haemorrhages.…”

Facteurs de risque et morbidité maternelle et néonatale des échecs d’extraction instrumentale par forceps

“…D'ailleurs, la méta-analyse de la Cochrane va dans le sens d'une augmentation des échecs d'extraction instrumentale (7,2 % pour les forceps et 11,6 % pour les ventouses) [7]. Les premières études sur les échecs de forceps sont anciennes et présentent des biais méthodologiques (essentiellement sur le choix du group témoin) rendant prudente l'interprétation des résultats [3][4][5].…”