Vacuum extraction and neonatal jaundice

Abstract

Various fetal scalp lesions are related to the use of the vacuum extractor. Blood sequestered in these lesions could result in an increased bilirubin load on the functionally limited neonatal liver, leading to the development of hyperbilirubinemia. In the present study bilirubin levels of vacuum extracted neonates were compared with those of non-instrumentally delivered babies during the first 72 hours of life. Sixty-nine vacuum extracted neonates had higher bilirubin levels than 56 non-instrumentally delivered babies at 24 (114 mumol/l vs. 96 mumol/l), 48 (163 vs. 141) and 72 (194 vs. 144) hours of age. The p values were 0.05, less than 0.025 and less than 0.001 respectively. This trend was apparent in both oxytocin induced and non-induced deliveries and whether or not phototherapy cases were included in the analysis. The incidence of hyperbilirubinemia requiring phototherapy was higher after vacuum extraction than after non instrumental delivery (27.5% vs. 12.5%; p less than 0.04). Analysis of our results unexpectedly indicated that oxytocin induction was generally associated with an attenuation of bilirubin levels after both vacuum extraction and spontaneous delivery. The clinician attending newborn babies should be aware of the higher incidence of neonatal hyperbilirubinemia associated with vacuum extraction.

Assisted delivery of mobile fetal head: a comparison of forceps, vaccum and assisted manual extraction of head at caesarean section

“…Study done by Arad I et al and Banu F et al showed that there was no significant difference in gestational age between the two groups. 5,6 In the present study, there was no significant difference in gestational age between manual and forceps extraction groups (P=0.42), between forceps and vacuum extraction groups (P=0.43) and between manual and vacuum extraction groups (P=0.42) ( Table 4).…”

“…In the study done by Arad I et al the U-D interval in the manual extraction group was 40.9±9.8 seconds and in the Vacuum extraction group it was 79.4±10.2 seconds. 5 Sritippayawan S et al found the U -D interval in the manual extraction and vacuum extraction group to be 86.3±53.9 seconds and 65.3±31.2 seconds respectively. 2 The U-D interval in the manual and vacuum extraction group was 43.5±8.6 seconds and 75.6±9.02 seconds respectively, in the study done by Banu F et al 6 The difference in U-D interval was found to be significant in the studies done by Arad I et al (P<0.01), Sritippayawan, S et al (P<0.001) and Banu F et al (P≤0.0001).…”

Onset of vacuum-related complaints in neonates

“…She had to be admitted to the special care baby unit. Three other neonates in the complaints group also had to be admitted to the special care baby unit due to feeding difficulties (2) or hyperbilirubinemia that required phototherapy (1). All vacuum extraction-related complaints occurred within the first 7-10 h following birth (see Table 2).…”

“…Hyperbilirubinemia requiring phototherapy has been observed more often after vacuum extraction than after spontaneous delivery [2,4,15]. Hyperbilirubinemia following vacuum extraction might be associated with resorption of head skin and cephalic hematoma that have been described in vacuum-delivered neonates [12,18,19,[23][24][25][26].…”