WOMEN'S HEALTH: Edited by Joseph AquilinaRotational vaginal delivery with Kielland's forceps a systematic review and meta-analysis of effectiveness and safety outcomesAl Wattar, Bassel H.a; Wattar, Baihas Alb; Gallos, Ioanisb,c; Pirie, Alexander M.b,cAuthor Information aWomen's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London bBirmingham Women's NHS Foundation Trust cBirmingham University, Birmingham, UK Correspondence to Bassel H. Al Wattar, MD, PGD, Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. Tel: +44 751 031 1359; e-mail: [email protected] Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-obgyn.com). Current Opinion in Obstetrics and Gynecology: December 2015 - Volume 27 - Issue 6 - p 438-444 doi: 10.1097/GCO.0000000000000221 Buy SDC Metrics Abstract Purpose of review The use of Kielland's forceps has declined significantly in the last three decades. There is a lack of quality evidence on potential benefits and harms associated with using these forceps. We have performed a systematic review of the literature and meta-analysis to assess the safety and efficacy of using Kielland's forceps. Recent findings We have searched electronic databases for all clinical studies reporting primary data on using Kielland's forceps and assessed their risk of bias using the Newcastle–Ottawa Scale. We have pooled the event rate of adverse outcomes reported following the use of Kielland's forceps including a direct comparison to rotational ventouse. In total we included 23 studies. Direct comparison meta-analysis revealed higher failure rate with rotational ventouse compared with Kielland's. There was no statistically significant difference in the risk of adverse maternal outcomes between the two groups. There was higher risk of neonatal trauma in the ventouse group, but no significant difference in other neonatal outcomes. Summary Kielland's forceps have a high success rate with relatively low adverse outcomes despite their use being controversial. In comparison to rotational ventouse, Kielland's forceps have higher efficacy with less risk of neonatal trauma. Copyright © 2015 YEAR Wolters Kluwer Health, Inc. All rights reserved.