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Neonatal Acidosis and Method of Delivery

From the Department of Obstetrics and Gynecology, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas

Abstract

Seven hundred and four women who had a forceps termination (177 elective, 293 indicated low, and 234 indicated midforceps) of labor over 24 months were compared with 303 spontaneous and 111 cesarean deliveries over the same time period. There was no significant difference between indicated low or midforceps either for fetal distress or arrest of descent with regard to fetal acidosis (pH <7.20), one- or five-minute Apgar scores less than 7, fetal trauma, or neurologic deficit at discharge. Fourteen percent of indicated forceps for arrest of descent had neonatal acidosis, versus 8% of cesarean sections for cephalopelvic disproportion (P=NS), and 23% of indicated forceps for fetal distress had acidosis, versus 33% of cesarean sections (P=not significant). There was no significant difference either in the incidence of acidosis or in low Apgar scores in neonates delivered by elective low forceps compared with those born by spontaneous vaginal delivery. The only significant differences in midforceps versus low forceps were between maternal pre- and postdelivery hematocrits (P<.0001) and vaginal lacerations (P<.0001). The authors' data support the continued usage of indicated low and selected midforceps operations.