1. Rotational Forceps: Which technique is superior for blade insertion? A simulation study comparing direct, first posterior, and wandering maneuvers.
- Author
-
Cuerva, Marcos Javier, Canilhas, Barbara, Aleixo, Vasco, Cruset, Mariona, Cortes, Marta, Lopez, Francisco, and Bartha, José Luis
- Subjects
- *
OBSTETRICAL forceps , *FORCEPS , *OBSTETRICIANS , *NUMBER theory , *SIMULATION methods & models - Abstract
• This is the first study attempting to provide scientific evidence on the various maneuvers for the insertion of the blades in rotational forceps. • The best results were obtained with the direct maneuver. • Inserting the posterior blade first was the maneuver with the worst results. The Kielland's forceps is the most used forceps for assisting rotational operative births. There are various maneuvers described for blade insertion. Among these, the most used ones are the direct, first posterior, and wandering maneuver. The objective of this study was to compare these three maneuvers using a simulator. In this experimental study, 144 rotational forceps-assisted births were conducted using a simulation model, with 72 starting in a right occiput-transverse position and 72 in a left occiput-transverse position. Each of the three maneuvers (direct, first posterior, or wandering) for blade insertion was performed 48 times by a total of 6 operators, comprising 3 obstetricians with over 10 years of experience and 3 trainees. The assessment of forceps application included evaluating the placement of the blades in terms of asymmetry and the distance from the lock to the posterior fontanelle. Additionally, the study evaluated the number of reinsertions and relocations required, the perceived difficulty of the procedure, and the operator's level of experience. There were no statistically significant differences in terms of asymmetry with the three maneuvers. Regarding the distance from the lock to the posterior fontanelle, the best results were obtained with the direct maneuver. There were no differences in the number of reinsertions, relocations, and the perceived difficulty by the operators among the three maneuvers. Experienced obstetricians had better outcomes in terms of the need for reinsertions. The direct maneuver offer advantages in the insertion of blades for rotational forceps. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF