Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates

Dupuis, Olivier; Silveira, Ruimark; Dupont, C.; Mottolèse, C.; Kahn, Pierre; Dittmar, A.; Rudigoz, R.-C.

doi:10.1016/j.ajog.2004.06.035

Cited by 122 publications

(73 citation statements)

References 9 publications

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“…6,7 There are few studies investigating the morbidity related to rotational vacuum extraction or manual rotation. [8][9][10] In these case studies morbidity has been reported in comparison with the morbidity associated with a non-rotational operative vaginal delivery or a spontaneous vaginal birth.…”

Section: Introductionmentioning

confidence: 99%

Maternal and neonatal morbidity in relation to the instrument used for mid‐cavity rotational operative vaginal delivery: a prospective cohort study

Bahl

Venne

Macleod

et al. 2013

BJOG

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Objective To compare the maternal and neonatal morbidity associated with alternative instruments used to perform a mid-cavity rotational delivery.Design A prospective cohort study.Setting Two university teaching hospitals in Scotland and England.Population Three hundred and eighty-one nulliparous women who had a mid-cavity rotational operative vaginal delivery.Methods A data collection sheet was completed by the research team following delivery.Main outcome measures Postpartum haemorrhage, thirdand fourth-degree perineal tears, low cord pH, neonatal trauma, and failed or sequential operative vaginal delivery.Results One hundred and sixty-three women (42.8%) underwent manual rotation followed by non-rotational forceps delivery, 73 (19.1%) had a rotational vacuum delivery, and 145 (38.1%) delivered with the assistance of rotational (Kielland) forceps. The rates of postpartum haemorrhage were similar when comparing manual rotation with rotational vacuum (adjusted OR 1.42, 95% CI 0.66-3.98), and when comparing manual rotation with Kielland forceps (adjusted OR 1.22, 95% CI 0.71-2.88). The results were comparable for third-and fourth-degree perineal tears (adjusted OR 0.85, 95% CI 0.13-1.89; adjusted OR 0.94, 95% CI 0.39-1.82), low cord pH (adjusted OR 1.76, 95% CI 0.44-6.91; adjusted OR 1.12, 95% CI 0.44-2.83), neonatal trauma (adjusted OR 0.50, 95% CI 0.16-1.55; adjusted OR 3.25, 95% CI 0.65-16.17), and admission to the neonatal intensive care unit (adjusted OR 1.47, 95% CI 0.45-4.81; adjusted OR 1.04, 95% CI 0.49-2.19). The sequential use of instruments was less likely with manual rotation and forceps than with rotational vacuum delivery (0.6 versus 36.9%, OR 0.01, 95% CI 0.002-0.090).Conclusions Maternal and perinatal outcomes are comparable with Kielland forceps, vacuum extraction, and manual rotation, with few serious adverse outcomes. With appropriate training mid-cavity rotational delivery can be practiced safely, including the use of Kielland forceps.Keywords Mid-cavity, morbidity, operative vaginal delivery, prospective cohort study, rotational.Please cite this paper as: Bahl R, Van de Venne M, Macleod M, Strachan B, Murphy DJ. Maternal and neonatal morbidity in relation to the instrument used for mid-cavity rotational operative vaginal delivery: a prospective cohort study . BJOG 2013;120:1526-1533

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Section: Introductionmentioning

confidence: 99%

Maternal and neonatal morbidity in relation to the instrument used for mid‐cavity rotational operative vaginal delivery: a prospective cohort study

Bahl

Venne

Macleod

et al. 2013

BJOG

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“…Las lesiones de cabeza y cráneo en el recién nacido pueden llegar a tener una frecuencia considerable, reportándose incidencias variables, de hasta 1,7 a 59 por 10.000 nacimientos 4,5 . Un estudio multicéntrico realizado en Londres reportó una incidencia de fracturas de cráneo de 3,7 por cada 100.000 nacidos vivos, siendo 2,7 veces más frecuente su asociación con partos instrumentalizados, en comparación con aquellos catalogados como espontá-neos; en este último grupo se incluyeron partos vía vaginal o cesárea sin uso de fórceps 6 . Si bien el riesgo de lesiones mayores asociadas (hematoma subdural o subaracnoídeo) es infrecuente, existen casos reportados, asociados a fractura de cráneo o en ausencia de esta.…”

Section: Epidemiologíaunclassified

Fractura de Base de Cráneo en Recién Nacidos: Caso Clínico

2010

Rev. chil. pediatr.

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“…La revue de la littérature utilise Medline ® et PubMed ® et une revue des articles de la littérature en utilisant les mots clés « forceps » et « delivery ». Le travail expérimental a consisté en une coopération avec les ingénieurs de l'INSA de Lyon [5][6][7].…”

Section: Patientes Et Méthodesunclassified

“…Les extractions instrumentales ont pourtant des caractéristiques spécifiques : il s'agit de procédu-res complexes (nécessité de connaître le degré de hauteur, d'asynclitisme, de rotation etc. ), aveugles (réalisées dans un espace inaccessible au regard du tuteur), potentiellement dangereuses (responsables de complications potentiellement graves [5]), souvent urgentes et de moins en moins fréquentes (3000 accouchements par an, 12 internes, un taux de forceps de 6 %, 80 % des extractions faites par les internes, ce qui équi-vaut à 12 forceps par an et par interne). Ces cinq caractéristi-ques compliquent nettement la tâche des meilleurs pédagogues et rendent l'apprentissage de la pose lors d'un véritable accouchement difficile et périlleuse.…”

Section: Introductionunclassified

Les forceps hier, aujourd'hui et demain. Une nouvelle classification des forceps

Dupuis

Moreau

Silveira

et al. 2005

Gynécologie Obstétrique & Fertilité

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Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates

Cited by 122 publications

References 9 publications

Maternal and neonatal morbidity in relation to the instrument used for mid‐cavity rotational operative vaginal delivery: a prospective cohort study

Maternal and neonatal morbidity in relation to the instrument used for mid‐cavity rotational operative vaginal delivery: a prospective cohort study

Fractura de Base de Cráneo en Recién Nacidos: Caso Clínico

Les forceps hier, aujourd'hui et demain. Une nouvelle classification des forceps

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