Main findings
The key findings from the study are that ventouse delivery performed poorly in comparison to other instrumental delivery modes in achieving vaginal delivery in obstetric theatre trials once baseline factors, including fetal position and station, are taken into account. Additionally, Keilland’s delivery had a lower chance of composite risk outcome when compared with primary emergency Caesarean delivery in a multivariate model adjusted for factors that can influence the outcome of delivery. The predictive value of the model performed poorly and therefore the authors do not conclude that Keilland’s forceps presents reduced risk to women and their babies when compared to primary full dilatation Caesarean; however, the data does suggest that attempting Keilland’s forceps delivery in this situation is reasonable, and is not associated with greater immediate perinatal risk than full dilatation Caesarean.