Journal
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Volume 35, Issue 22, Pages 4375-4380Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14767058.2020.1849122
Keywords
Failed vacuum; cesarean section; second stage of labor; operative vaginal birth
Categories
Ask authors/readers for more resources
This study compared the pregnancy outcomes of women who underwent cesarean section in the second stage of labor, with or without a vacuum extraction attempt. The results showed that failed vacuum attempts were associated with increased neonatal morbidity, but not increased maternal morbidity.
Objective To compare the pregnancy outcome of women who underwent cesarean section in the second stage of labor, with or without a vacuum extraction attempt Methods A retrospective cohort study of women who underwent a cesarean section during the second stage of labor in a single tertiary university-affiliated medical center (2012-2019). Pregnancy outcome was compared for women who underwent cesarean section following a failed vacuum extraction to women who had cesarean section during the second stage of labor with no vacuum extraction attempt. Neonatal outcomes included umbilical artery pH less than 7.1, Apgar at 5 min < 7, hypoxemic ischemic encephalopathy and NICU admission. Maternal outcomes included duration of hospitalization, need for blood transfusion and need for re-surgery in 45 days. Results Overall, 88,375 women delivered during the study period. Of them, 120 women had a cesarean section following a failed vacuum (study group). Another 551 women underwent a cesarean section in the second stage of labor without a VE attempt (control group). The groups were similar with regard to obstetrical and demographic characteristics. The rates of umbilical artery pH < 7.1 (17.50% vs 6.53%, p < .001), NICU admission (13.33% vs 2.90%, p < .001), hypoxemic ischemic encephalopathy (5.83% vs 0.18%, p < .001) and epicranial sub-aponeurotic hemorrhage (16.67% vs 2.18%, p < .001) were significantly higher in the study group. No significant differences were found in maternal outcomes. In a sub-analysis including only labor with reassuring fetal heart tracing, failed vacuum attempt was associated with higher rate of NICU admission and epicranial hemorrhage (16.67% vs 3.13%, p = .009, 27.78% vs. 3.41, p = .001, respectively). Conclusion Failed vacuum attempt is associated with a significant increased neonatal morbidity, but not increased maternal morbidity
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available