Neonatal complications in vacuum-assisted vaginal delivery: are they associated with number of pulls, cup detachments, and duration of vacuum application? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-01

AUTHORS

Alessandro Ghidini, Daniel Stewart, John C. Pezzullo, Anna Locatelli

ABSTRACT

PURPOSE: To explore whether the characteristics of vacuum delivery are associated with the occurrence of head injury and neonatal complications. METHODS: 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. RESULTS: 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. CONCLUSION: Neonatal head injury after vacuum application is not independently related to total duration of vacuum application, number of pulls, or cup dislodgements. More... »

PAGES

67-73

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00404-016-4206-7

DOI

http://dx.doi.org/10.1007/s00404-016-4206-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032273617

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27677283


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