We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Neonatal complications in vacuum-assisted vaginal delivery: are they associated with number of pulls, cup detachments, and duration of vacuum application?
- Authors
Ghidini, Alessandro; Stewart, Daniel; Pezzullo, John; Locatelli, Anna; Pezzullo, John C
- Abstract
<bold>Purpose: </bold>To explore whether the characteristics of vacuum delivery are associated with the occurrence of head injury and neonatal complications.<bold>Methods: </bold>Retrospectively cohort study of vacuum-assisted attempted vaginal deliveries of singletons. We studied the association of total duration of vacuum application and number of pulls and cup dislodgement with (1) primary outcome: the occurrence of major (subgaleal hemorrhage, skull fracture, and intracranial hemorrhage) or minor (cephalohematoma, scalp laceration more extensive than simple abrasions) neonatal head injuries and (2) secondary outcome: the occurrence of neonatal complications, including 5-min Apgar score <7, umbilical artery pH < 7.10, shoulder dystocia, or need for neonatal intensive care unit admission. Logistic regression analysis was used to control for confounders.<bold>Results: </bold>Vacuum-assisted delivery was attempted in 555 women. It was successful in 515 cases, and it failed in 40 (7.2 %). Head injury occurred in 32 (6.2 %) of vaginally delivered neonates, and it was related to duration of vacuum application (P = 0.004) and birth weight (P = 0.048). However, the associations lost a statistical significance at the multivariate analysis. Neonatal complications occurred in 25 cases (5 %), and they were associated with meconium-stained amniotic fluid (P < 0.001) and duration of vacuum application (P = 0.03) at the multivariate analysis. However, most of the complications were actually associated with the need for vacuum delivery rather than the procedure itself.<bold>Conclusion: </bold>Neonatal head injury after vacuum application is not independently related to total duration of vacuum application, number of pulls, or cup dislodgements.
- Subjects
DELIVERY (Obstetrics); HEAD injuries; NEWBORN infants' injuries; INTENSIVE care units; HOSPITAL admission &; discharge; MULTIVARIATE analysis; AMNIOTIC liquid
- Publication
Archives of Gynecology & Obstetrics, 2017, Vol 295, Issue 1, p67
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-016-4206-7