Early Maternal and Neonatal Morbidity Associated With Operative Delivery in Second Stage of Labour: A Cohort Study

Murphy, Deirdre J; Liebling, Rachel; Verity, Lisa; Swingler, Rebecca; Patel, Roshni

doi:10.1097/00006254-200204000-00007

Cited by 62 publications

(106 citation statements)

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“…[14] In a prospective cohort study in Bristol, UK, the outcomes of mothers and neonates after delivery by second-stage CD were compared with the outcomes after AVD in theatre (anticipated difficult AVD). [15] The patients delivered by CD had significantly more haemorrhage (>1 000 mL), a higher rate of prolonged hospital stay (>6 days) and more neonatal intensive care unit admissions due to low Apgar scores and low umbilical artery pH. The haemorrhage was also more severe if the CD was performed by a less skilled surgeon.…”

Section: Fetal Indicationsmentioning

confidence: 94%

Failure to perform assisted deliveries is resulting in an increased neonatal and maternal morbidity and mortality: An expert opinion

et al. 2018

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Section: Fetal Indicationsmentioning

confidence: 94%

Failure to perform assisted deliveries is resulting in an increased neonatal and maternal morbidity and mortality: An expert opinion

et al. 2018

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“…2 Failure to identify a malposition (especially an occipito-posterior position) is one of the factors that increases the likelihood of failed instrumental delivery and neonatal trauma. [13][14][15][16][17][18][19] The fetal head position is diagnosed on vaginal examination by delineating the suture lines of the fetal skull and fontanelles; however, accurate clinical diagnosis can be unreliable, varying between 20 and 75%. [20][21][22][23][24][25][26][27][28][29] The use of abdominal ultrasound to enhance the diagnosis of the fetal head position has been described in a number of small studies, but only two have evaluated the role of ultrasound at instrumental delivery.…”

Section: Introductionmentioning

confidence: 99%

Instrumental delivery and ultrasound : a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Ramphul

Ooi

Burke

et al. 2014

BJOG

130

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Objective To determine whether the use of ultrasound can reduce the incidence of incorrect diagnosis of the fetal head position at instrumental delivery and subsequent morbidity. Design Two‐arm, parallel, randomised trial, conducted from June 2011 to December 2012. Setting Two maternity hospitals in the Republic of Ireland. Sample A cohort of 514 nulliparous women at term (≥37 weeks of gestation) with singleton cephalic pregnancies, aiming to deliver vaginally, were recruited prior to an induction of labour or in early labour. Methods If instrumental delivery was required, women who had provided written consent were randomised to receive clinical assessment (standard care) or ultrasound scan and clinical assessment (ultrasound). [Correction added on 17 April 2014, after first online publication: Sentence was amended.] Main outcome measure Incorrect diagnosis of the fetal head position. Results The incidence of incorrect diagnosis was significantly lower in the ultrasound group than the standard care group (4/257, 1.6%, versus 52/257, 20.2%; odds ratio 0.06; 95% confidence interval 0.02–0.19; P < 0.001). The decision to delivery interval was similar in both groups (ultrasound mean 13.8 minutes, SD 8.7 minutes, versus standard care mean 14.6 minutes, SD 10.1 minutes, P = 0.35). The incidence of maternal and neonatal complications, failed instrumental delivery, and caesarean section was not significantly different between the two groups. Conclusions An ultrasound assessment prior to instrumental delivery reduced the incidence of incorrect diagnosis of the fetal head position without delaying delivery, but did not prevent morbidity. A more integrated clinical skills‐based approach is likely to be required to prevent adverse outcomes at instrumental delivery.

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“…The Cochrane database has displayed that maternal morbidity is less in the vacuum group than in the forceps group. It has been displayed that the anesthesia requirement in vacuum application and the pain during and after delivery are reduced (10,23,24).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Maternal and Neonatal Outcomes of Operative Vaginal Deliveries: Vacuum vs. Forceps

Çetin¹,

Bahat²,

Köroğlu³

et al. 2017

Istanbul Med J

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The term operative vaginal delivery refers to a delivery in which the operator uses an instrument to extract the fetus from the vagina. The two alternatives for instrument are vacuum and forceps (1, 2). The surgical alternative to operative vaginal deliveries is cesarean section (3,4).Recently, the rates of birth by cesarean have risen throughout the world. With operative vaginal deliveries, cesarean section can be avoided, as well as morbidity and mortality caused by it. In many studies, the comparison of vacuum and forceps instruments has been made (5-8). In both the methods, the risk for the mother and the fetus rises, compared to spontaneous vaginal deliveries. There are different rates of maternal and neonatal complications listed in the literature. Poor maternal and neonatal outcome has been reported after the consecutive use of vacuum and forceps (9). Moreover, it has been shown that maternal injuries are more frequent and severe. Although operative vaginal delivery rate has not changed over the years, the rate of forceps use has decreased, and the rate of vacuum use has risen (10-11).In the light of such information, it was aimed to compare the indications, complications, and maternal and neonatal results of forceps and vacuum applications in operative vaginal deliveries at our clinic, which is a tertiary health center, considering the literature information. Material and MethodsOur study is a retrospective study that was conducted at İstanbul Kanuni Sultan Süleyman Education and Research Hospital between January 2016 and December 2016. Operative vaginal deliveries were examined from the hospital records following our hospital's ethics committee approval. A total of 105 operative deliveries were performed in our hospital between these dates. Patient consent was obtained before all the procedures. Seven cases were excluded from the study due to missing registries. A total of 98 operative vaginal deliveries were included in this retrospective study. Fifty-five forceps cases and 43 vacuum cases were compared in terms of demographic data, indications, and maternal and neonatal results. Exclusion criteria were multiple pregnancies, preterm birth, and in utero mort fetuses. Comparison of Maternal and Neonatal Outcomes of Operative Vaginal Deliveries: Vacuum vs. ForcepsObjective: A vaginal delivery accomplished using either forceps or vacuum is termed as operative vaginal delivery. The aim of this study is to compare indications of maternal and neonatal outcomes between operative vaginal deliveries using forceps (the forceps group) and vacuum (the vacuum group) at our tertiary institute.Methods: This is a retrospective observational study on operative vaginal deliveries performed between January 2016 and December 2016 at a tertiary hospital in Istanbul. All patients who underwent instrumental vaginal delivery were compared in terms of demographic data, indications, and maternal and neonatal outcomes. Results:The incidence of operative vaginal delivery was 1.4% of all deliveries. Most patients were primigravida....

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Early Maternal and Neonatal Morbidity Associated With Operative Delivery in Second Stage of Labour: A Cohort Study

Cited by 62 publications

References 0 publications

Failure to perform assisted deliveries is resulting in an increased neonatal and maternal morbidity and mortality: An expert opinion

Failure to perform assisted deliveries is resulting in an increased neonatal and maternal morbidity and mortality: An expert opinion

Instrumental delivery and ultrasound : a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Comparison of Maternal and Neonatal Outcomes of Operative Vaginal Deliveries: Vacuum vs. Forceps

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