During operative vaginal delivery with a Kielland's forceps, the fetus is LOT (left occiput transverse) position. The forceps are applied correctly and rotation to OA is performed. Which complication is SPECIFICALLY associated with Kielland's forceps compared to Neville-Barnes forceps?
- A Tentorial tear due to rotation in mid-cavity ✓
- B Facial nerve palsy
- C Cephalohematoma
- D Erb's palsy
Correct answer: A. Tentorial tear due to rotation in mid-cavity
Explanation
Kielland's forceps have minimal pelvic curve allowing rotation in mid-cavity, specifically designed for transverse/oblique positions. However, rotational forceps delivery carries a specific risk of tentorial tear due to the torsional forces applied to the fetal head in the mid-cavity. Neville-Barnes (non-rotational) forceps are used for outlet or low-cavity OA/OP deliveries. Facial nerve palsy and cephalohematoma occur with all types of forceps. Erb's palsy relates to shoulder dystocia, not forceps.
Reference: Williams Obstetrics, 26th ed.
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