Naegele Forceps Delivery and Association between Morbidity and the Number of Forceps Traction Applications: A Retrospective Study
Table 3
Relationship between patient characteristics and morbidity.
Factors
Maternal anal sphincter injury (n = 31)
Acute postpartum urinary retention lasting over 24 h (n = 12)
Dehiscence and maternal injury except for perineal lacerations (n = 5)
Neonatal facial injuries (n = 16)
Umbilical artery acidemia (n = 8)
%
P
%
P
%
P
%
P
%
P
Gestational age at delivery
Early term (37 0/7-38 6/7 weeks)
35.7
0.85
16.7
0.73
5.3
>0.99
25.0
0.56
10.5
>0.99
Full term (39 0/7-40 6/7 weeks)
31.6
12.5
7.1
26.3
8.9
Late term (41 0/7 weeks and after)
41.7
16.7
0.0
16.7
8.3
Maternal age
≥35 years
48.0
0.15
11.3
0.31
4.0
>0.99
12.0
0.54
4.0
0.43
<35 years
30.7
20.8
6.5
21.0
11.3
Parity
Nullipara
37.5
0.56
12.7
0.44
6.9
0.39
20.8
0.29
9.3
>0.99
Multipara
26.7
20.0
0.0
6.7
6.7
Maternal complications
Yes
27.0
0.15
16.7
0.55
2.7
0.30
32.4
0.005
5.4
0.46
No
42.0
12.0
8.0
8.0
12.0
Maternal height
<155 cm
36.0
>0.99
12.0
>0.99
8.0
0.63
28.0
0.22
4.0
0.43
≥155 cm
35.5
14.8
4.8
14.5
11.3
Maternal BMI at labor
≥29 kg/m2
50.0
0.46
37.5
0.064
0.0
>0.99
12.5
1
0.0
>0.99
<29 kg/m2
34.6
10.4
6.4
19.2
10.3
Neonatal birth weight
≥3500 g
35.7
>0.99
7.1
0.70
0.0
0.59
21.4
0.72
7.1
>0.99
<3500 g
35.6
15.3
6.9
17.8
9.6
Augmentation
Yes
43.8
0.12
10.3
0.54
6.3
>0.99
25.0
0.099
6.3
0.46
No
25.6
17.0
5.1
10.3
12.8
Epidural analgesia
Yes
38.9
0.79
22.2
0.27
1.1
0.28
22.2
0.74
5.6
>0.99
No
34.8
11.8
4.4
17.4
10.1
Episiotomy
Yes
40.0
0.51
5.7
0.12
8.6
0.39
20.0
0.79
2.9
0.14
No
32.7
19.6
3.9
17.3
13.5
Fetal head malrotation
Yes
42.9
0.56
7.1
0.69
0.0
0.59
64.3
<0.001
7.1
>0.99
No
34.3
15.3
6.9
9.6
9.6
Station
≤+2 cm
27.9
0.26
14.3
>0.99
4.7
>0.99
20.9
0.79
11.6
0.71
>+2 cm
41.9
14.0
7.0
16.3
7.0
Chief indication
Prolonged second stage
43.1
0.11
16.0
0.85
5.9
>0.99
23.5
0.053
2.0
0.0053
Nonreassuring fetal status
24.2
12.1
3.0
6.1
26.9
Severe PIH
33.3
0.0
0.0
66.7
0.0
Numbers of forceps traction applications
1
34.5
0.58
16.7
0.58
7.3
>0.99
7.3
<0.001
5.5
0.14
2
42.9
14.3
4.8
19.0
14.3
≥3
22.2
0.0
0.0
88.9
22.2
Percentages mean proportions of the morbidity in each factor. P values were calculated using Fisher’s exact test. BMI: body mass index; PIH: pregnancy-induced hypertension. Statistically significant. Chief indication of severe PIH was excluded from the statistical test because of the lack of the cases (n = 3).