Single Blade Forceps versus Manual Delivery of Fetal Head during Cesarean Section: A randomized controlled trial
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Abstract
Objective: We aimed to compare the efficacy of single blade forceps vs. manual delivery during cesarean section vis-à-vis time to deliver the fetal head and maternal and neonatal outcomes.
Materials and Methods: One hundred and forty-four pregnant women were randomly assigned to single blade forceps or manual delivery. The women were term, singleton, cephalic presentation, undergoing a low transverse cesarean section under spinal anesthesia. The primary outcome was time to deliver the fetal head. The secondary outcomes included operative time, maternal outcomes (unintended excision of uterine incision, uterine vessels injury), neonatal outcomes (APGAR score at 5 and 10 min, oxygen need for resuscitation, and neonatal injury), and surgeon satisfaction.
Results: Baseline characteristics were comparable between groups except for the type of skin incision. Median time to delivery of the fetal head using single blade forceps was statistically shorter than using the manual delivery (24.50 s (IQR, 10.50-41.50) vs. 45.00 s (IQR, 19.50-92.00), p-value < 0.001). Similar results occurred for operative time, maternal outcomes, neonatal outcomes, and surgeon satisfaction. Minor neonatal injury was 9.72 percent in the single blade forceps group.
Conclusion: Using single blade forceps shortened the delivery of the fetal head during cesarean section without serious maternal and neonatal complications. Minor neonatal injury was more common in the single blade forceps group than the manual delivery group.
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