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Poster Session 4

Category: Operative Obstetrics

Poster Session 4

(1123) Maternal Outcomes in Forceps-Assisted Cesarean Delivery

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Presenting Author(s)

Jessica D. Sisco, MD

Resident
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Submitting Author(s)

Alesha M. White, MD (she/her/hers)

Maternal Fetal Medicine Fellow
University of Texas Southwestern Medical Center
Grand Prairie, Texas, United States

Coauthor(s)

JP

Jessica E. Pruszynski, PhD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
Elaine L. Duryea, MD

Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective:
Maternal outcomes in cases of operative vaginal deliveries are well established. The purpose is to examine maternal outcomes in forceps-assisted cesarean deliveries (FACD).

Study Design:
This is a retrospective cohort study of patients delivering liveborn, singleton neonates via FACD at a single institution between January 2014 and December 2023. Patients were compared to a 1:1 random sampling of patients delivered via CD without forceps during the same study period. Maternal demographics and delivery characteristics were examined. A logistic regression adjusting for stage of labor prior to CD, indication for CD and hypertensive disorders of pregnancy was performed.

Results:
2021 patients were included in each cohort. FACDs were more likely to be performed in multiparous, non-laboring patients via low transverse hysterotomy undergoing repeat CD (all p< 0.001). They were less likely to have gestational hypertension (18% vs 24%, p< 0.001) and pre-eclampsia (9% vs 14%, p< 0.001) but more likely to have overt diabetes (6% vs 4%, p= 0.002) (Table 1). In terms of delivery outcomes, FACDs were associated with longer extraction times (3 minutes (2-4) vs 1 minute (1-2), p< 0.001), but less likely to develop chorioamnionitis, require blood transfusion, or to undergo hysterectomy (all p< 0.05). No significant difference was found in rates of postpartum hemorrhage or in the overall number of products transfused. After logistic regression, only rate of hysterectomy remained significant (Table 2).

Conclusion:
Though associated with longer extraction times, cesarean forceps were not associated with increased adverse maternal outcomes. In low-risk CDs, forceps are reasonable tools to use to assist with delivery.