Vacuum extraction is a risk factor for serious neonatal complications, in particular when used in macrosomic fetuses.

BACKGROUND: Before hospital discharge, newborn infants should be assessed for the risk of excessive hyperbilirubinemia. We determined maternal and obstetric risk factors for hyperbilirubinemia in infants born at term (gestational age $37 weeks) to form an individualized risk assessment tool for clinical use.

To describe the duration, progression and patterns of first stage of labor among Swedish women. Design Population-based cohort study. Population Data from Stockholm-Gotland Obstetric Cohort 2008-2014 including ¼ of all births in Sweden, the final sample involved a total of 85,408 women with term, singleton, vertex, live fetuses experiencing spontaneous labor onset and vaginal delivery with normal neonatal outcomes. Main outcome measures Time to progress during first stage of labor using three approaches: 1) Traverse time in hours to progress centimeter to centimeter, 5 th , 50 th (and 95 th percentile); 2) Dilation curves for different percentiles, and; 3) Cumulative duration for the 95 th percentile by parity and dilation at admission. Results Variation in both the total duration and the trajectory of cervical change over time is large. Similar to the general held view, the rate of cervical dilation accelerates at 5-6 centimeters. Among nulliparous women, the median time found in our population was faster than their

Despite a probable selection of women who before-hand were considered at low risk and, therefore, could be recommended vaginal breech delivery, infants delivered in vaginal breech faced substantially increased risks of severe neonatal complications compared with infants in breech presentations delivered by elective CS. Key message Vaginal breech delivery is associated with increased risk for severe neonatal complications.

Extraction time >15 min, >6 pulls and >1 cup detachment is associated with increased risk of neonatal complications. These results support compliance with guidelines and recommendations for VE deliveries.