Instrumental vaginal delivery

Sullivan, Charlotte; Hayman, Richard

doi:10.1016/j.ogrm.2008.01.008

Cited by 9 publications

(13 citation statements)

References 3 publications

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“…The need for instrumental labor always indicates a problem during the 2nd stage, when birth has to be expedited [25]; thus, it is not surprising that the percentage of babies with SDH was higher in this group (44%, P < 0.0001). Subdural hemorrhage is seen in cesarean sections independently of whether the head is engaged or not, the mechanism being one of hypoxic and not mechanical trauma, as emergency cesarean sections are carried out when there is fetal distress.…”

Section: Discussionmentioning

confidence: 99%

Nontraumatic Intradural and Subdural Hemorrhage and Hypoxic Ischemic Encephalopathy in Fetuses, Infants, and Children up to Three Years of Age: Analysis of Two Audits of 636 Cases from Two Referral Centers in the United Kingdom

et al. 2013

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We analyzed the presence or absence of intradural hemorrhage (IDH) and subdural hemorrhage (SDH) and the degree of hypoxic-ischemic encephalopathy (HIE) in the brain of all nonmacerated fetuses of >24 weeks, neonates, and children up to 3 years of age who died of natural causes over a defined period. We looked into the cause of death and the performance of cardiopulmonary resuscitation in our cohort. The IDH was classified as macroscopic or negative/microscopic only; the HIE was classified as absent, indeterminate, or definite. In fetuses, SDH with IDH was present in 22%; IDH alone was present in 31%, and there was no or minimal hemorrhage in 47% of cases. In infants and children SDH with IDH was present in 19%; IDH alone was present in the 32%, and there was no or minimal hemorrhage in 49% of cases. There was a statistically significant correlation between SDH and HIE, especially in infants and children (P < 0.001). When cases were grouped per age, a significant association between age and hemorrhage (P < 0.0001) was demonstrated, SDH being more common in infants ≤1 month corrected age. Intradural hemorrhage can be the source of thin-film SDH in fetuses, infants, and young children. The presence of SDH is associated with hypoxia. Intradural and subdural hemorrhages are more common in autopsies of infants under 1 month corrected age. Although more rare, they can also be found in children between 1 month and 3 years of age in the absence of trauma.

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Section: Discussionmentioning

confidence: 99%

Nontraumatic Intradural and Subdural Hemorrhage and Hypoxic Ischemic Encephalopathy in Fetuses, Infants, and Children up to Three Years of Age: Analysis of Two Audits of 636 Cases from Two Referral Centers in the United Kingdom

et al. 2013

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“…Instrumental vaginal birth is an intervention which affects between 10 - 25% of all nulliparous women in the industrialised world [ 19 ]. Instrumental vaginal births are considered as births assisted by vacuum extraction or forceps [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Instrumental vaginal births are considered as births assisted by vacuum extraction or forceps [ 20 ]. Internationally, the most common medical indications for instrumental vaginal birth are suspected fetal compromise followed by prolonged second stage of labor [ 19 , 21 ]. A commonly occurring non-medical indication is maternal exhaustion [ 19 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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No reduction in instrumental vaginal births and no increased risk for adverse perineal outcome in nulliparous women giving birth on a birth seat: results of a Swedish randomized controlled trial

Thies-Lagergren

Kvist

Christensson

et al. 2011

BMC Pregnancy Childbirth

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BackgroundThe WHO advises against recumbent or supine position for longer periods during labour and birth and states that caregivers should encourage and support the woman to take the position in which she feels most comfortable. It has been suggested that upright positions may improve childbirth outcomes and reduce the risk for instrumental delivery; however RCTs of interventions to encourage upright positions are scarce. The aim of this study was to test, by means of a randomized controlled trial, the hypothesis that the use of a birthing seat during the second stage of labor, for healthy nulliparous women, decreases the number of instrumentally assisted births and may thus counterbalance any increase in perineal trauma and blood loss.MethodsA randomized controlled trial in Sweden where 1002 women were randomized to birth on a birth seat (experimental group) or birth in any other position (control group). Data were collected between November 2006 and July 2009. The primary outcome measurement was the number of instrumental deliveries. Secondary outcome measurements included perineal lacerations, perineal edema, maternal blood loss and hemoglobin. Analysis was by intention to treat.ResultsThe main findings of this study were that birth on the birth seat did not reduce the number of instrumental vaginal births, there was an increase in blood loss between 500 ml and 1000 ml in women who gave birth on the seat but no increase in bleeding over 1000 ml and no increase in perineal lacerations or perineal edema.ConclusionsThe birth seat did not reduce the number of instrumental vaginal births. The study confirmed an increased blood loss 500 ml - 1000 ml but not over 1000 ml for women giving birth on the seat. Giving birth on a birth seat caused no adverse consequences for perineal outcomes and may even be protective against episiotomies.Trial registration numberClinicalTrials.gov.ID: NCT01182038

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“…In this study, to investigate the in uences of using different materials of vacuum extractors and different vacuum pressures, nite element models of vacuum extractor and fetal head were established, and the design of vacuum extractor model was mainly hemispherical. According to previous literature [12], a cup of 5-cm diameter is suitable for nearly all deliveries, so the vacuum extractor model used herein was a hemispherical vacuum extractor with a diameter of 5 cm (Fig. 1).…”

Section: Building a Simulation Geometry Modelmentioning

confidence: 99%

Effects of Attraction of Vacuum Extractors of Different Materials and Pressures on the Fetal Head During Delivery

Chen

Tsai

et al. 2021

Preprint

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PurposeIn some cases where operative deliveries are required with vacuum extractor, and obstetricians could choose the vacuum extractor to facilitate the process smoother and safer. However, there is no related biomechanical literature about the influences of vacuum extractors fabricated from different materials and pressures of vacuum on the fetal head. Hence, we utilized the finite element method to investigate the influences of vacuum extractors manufactured from different materials on the fetal head under various extractive pressures.MethodsFirst, the finite element analysis models of vacuum extractor and fetal head were established. The vacuum extractor model was designed as a hemispherical shape and we compared silicone rubber and stainless steel for the materials of vacuum extractor. Subsequently, four different vacuum pressures were applied as the factors for investigation—500-cm H2O, 600-cm H2O, 700-cm H2O, and 800-cm H2O. Finally, we observed and analyzed the reactive force on the fetal head, von Mises stress of vacuum extractor, and von Mises stress on the skull of fetal head to evaluate the influences of vacuum extractors of different materials under different pressures. ResultsThe results demonstrated that different vacuum pressures had only a slight difference of influences on the fetal head. The use of stainless-steel vacuum extractors caused a relatively larger reactive force (358.04–361.37 N) and stress (13.547–13.675 MPa) on the fetal head. ConclusionsNon-metallic or relatively softer materials could be selected when using a vacuum extractor for operative delivery to avoid complications such as scalp scratch, and even cephalohematoma and intracerebral hemorrhage.

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Instrumental vaginal delivery

Cited by 9 publications

References 3 publications

Nontraumatic Intradural and Subdural Hemorrhage and Hypoxic Ischemic Encephalopathy in Fetuses, Infants, and Children up to Three Years of Age: Analysis of Two Audits of 636 Cases from Two Referral Centers in the United Kingdom

Nontraumatic Intradural and Subdural Hemorrhage and Hypoxic Ischemic Encephalopathy in Fetuses, Infants, and Children up to Three Years of Age: Analysis of Two Audits of 636 Cases from Two Referral Centers in the United Kingdom

No reduction in instrumental vaginal births and no increased risk for adverse perineal outcome in nulliparous women giving birth on a birth seat: results of a Swedish randomized controlled trial

Effects of Attraction of Vacuum Extractors of Different Materials and Pressures on the Fetal Head During Delivery

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