Giacchino T, Karkia R, Zhang W, et al. - Via this was a retrospective cohort study of 23,786 pregnancies, researchers sought to determine accurate estimates of risks of maternal and neonatal complications linked with Kielland rotational forceps delivery (KRFD) compared with rotational ventouse delivery (RVD) or 2nd stage caesarean section (CS). Among these pregnancies: 491 (2.1 %) required KRFD, 344 (1.4 %) required RVD, 840 (3.5 %) that had a 2nd stage CS and 22,111 (93.0 %) spontaneous cephalic vaginal deliveries. Significantly higher risk of PPH was noted in those delivering by a 2nd stage CS compared with KRFD (27.5 % vs 12.4 %). Highest risk of maternal composite adverse outcome was noted after 2nd stage CS and lowest after KRFD. Those delivering by RVD had higher risk of composite neonatal adverse outcome, relative to KRFD or 2nd stage CS. Outcomes thereby suggest that relative to RVD or 2nd stage CS, KRFD is a safer option for the management of persistent fetal malposition in labor.