2016
DOI: 10.1016/j.ajog.2015.11.007
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Evaluation of delivery options for second-stage events

Abstract: Background Cesarean delivery in the second stage of labor is common, whereas the frequency of operative vaginal delivery has been declining. However, data comparing outcomes for attempted operative vaginal delivery in the second stage versus cesarean in the second stage are scant. Previous studies that examine operative vaginal delivery have compared it to a baseline risk of complications from a spontaneous vaginal delivery and cesarean delivery. However, when a woman has a need for intervention in the second … Show more

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Cited by 63 publications
(42 citation statements)
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“…Higher rates of severe postpartum haemorrhage were also found in midcavity vacuum deliveries among women with dystocia. Increased rates of postpartum haemorrhage following vacuum delivery at low and outlet station has been reported previously, 34 although such reports were restricted to babies with birthweight ≥4000 g. Studies that have compared postpartum haemorrhage in midcavity operative vaginal deliveries and caesarean deliveries have yielded conflicting results 8,9,35,36 at least partly due to differences in definitions of postpartum haemorrhage. We defined severe postpartum haemorrhage as postpartum haemorrhage requiring transfusion to ensure a clinically meaningful and standardised outcome.…”
Section: Discussionmentioning
confidence: 95%
“…Higher rates of severe postpartum haemorrhage were also found in midcavity vacuum deliveries among women with dystocia. Increased rates of postpartum haemorrhage following vacuum delivery at low and outlet station has been reported previously, 34 although such reports were restricted to babies with birthweight ≥4000 g. Studies that have compared postpartum haemorrhage in midcavity operative vaginal deliveries and caesarean deliveries have yielded conflicting results 8,9,35,36 at least partly due to differences in definitions of postpartum haemorrhage. We defined severe postpartum haemorrhage as postpartum haemorrhage requiring transfusion to ensure a clinically meaningful and standardised outcome.…”
Section: Discussionmentioning
confidence: 95%
“…Indications for this approach include fetal distress, prolonged second stage of labor, maternal exhaustion, or the need to avoid expulsive efforts among women with conditions such as heart failure or severe anemia . Although vacuum extraction can reduce maternal mortality from hemorrhage and sepsis—as well as perinatal mortality from birth asphyxia—use of this method has almost disappeared from obstetric practice in many LMICs . One study found that instrumental vaginal delivery was not used in almost half of 1728 Sub‐Saharan African hospitals, with usage rates below 1% in the remaining centers.…”
Section: Introductionmentioning
confidence: 99%
“…6 The literature on perinatal and maternal mortality and morbidity after operative vaginal delivery compared with cesarean delivery is inconsistent. [7][8][9][10][11][12][13][14][15][16] In addition, studies on the risks and benefits of these Increased use of operative vaginal delivery (i.e., forceps or vacuum application), of which 20% occurs at midpelvic station, has been advocated to reduce the rate of cesarean delivery. We aimed to quantify severe perinatal and maternal morbidity and mortality associated with attempted midpelvic operative vaginal delivery.…”
mentioning
confidence: 99%