title: Naegele Forceps Delivery and Association between Morbidity and the Number of Forceps Traction Applications: A Retrospective Study.
abstract: OBJECTIVE
  To present the method of Naegele forceps delivery clinically practiced by the lead author, its success rate, and morbidity and to evaluate the relationship between morbidity and the number of forceps traction applications.
  
  
  METHODS
  Naegele forceps delivery was performed when the fetal head reached station +2 cm, the forceps were applied in the maternal pelvic application, and traction was slowly and gently performed. In the past two years, Naegele forceps delivery was attempted by the lead author in 87 cases, which were retrospectively reviewed.
  
  
  RESULTS
  The numbers of traction applications were one in 64.7% of cases, two in 24.7%, and three or more in 10.7%. The success rate was 100%. No severe morbidity was observed in mothers or neonates. Neonatal facial injury occurred most commonly in cases with fetal head malrotation, elevated numbers of traction applications, and maternal complications. Umbilical artery acidemia most commonly occurred in cases with nonreassuring fetal status. The significant crude odds ratio for three or more traction applications was 20 in cases with malrotation.
  
  
  CONCLUSIONS
  Naegele forceps delivery has a high success rate, but multiple traction applications will sometimes be required, particularly in cases with malrotation. Malrotation and elevated numbers of traction applications may lead to neonatal head damage.
authors.affiliation: Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, 96 Wakamatsucho, Takasaki, Gunma 370-0836, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsumoto
authors.affiliation: Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, 96 Wakamatsucho, Takasaki, Gunma 370-0836, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Takenaka
authors.affiliation: Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, 96 Wakamatsucho, Takasaki, Gunma 370-0836, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ikeda
authors.affiliation: Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, 96 Wakamatsucho, Takasaki, Gunma 370-0836, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yazaki
authors.affiliation: Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, 96 Wakamatsucho, Takasaki, Gunma 370-0836, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000209:etiology*; D005113:Extraction, Obstetrical / Q000009:adverse effects*; D005260:Female; D005316:Fetal Distress; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D009017:Morbidity; D007744:Obstetric Labor Complications; D009772:Obstetrical Forceps / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult