Prospective cohort study comparing outcomes between vacuum extraction and second‐stage cesarean delivery at a Ugandan tertiary referral hospital

Nolens, Barbara; Namiiro, Flavia; Lule, John; Akker, Thomas van den; Roosmalen, Jos van; Byamugisha, Josaphat

doi:10.1002/ijgo.12500

Cited by 28 publications

(84 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, fetal assessment on admission and monitoring during the second stage of labor were identified as key intrapartum points for perinatal survival, enabling triage and expedited instrumental vaginal delivery, respectively . A rapid, low‐cost, low‐technology triage algorithm based on the findings of risk assessment and physical examination—for example, an adapted version of the Intelligent Structured Intermittent Auscultation framework —to triage laboring women into appropriate levels of fetal monitoring in low‐resource settings might support the implementation of these recommendations.…”

Section: Discussionmentioning

confidence: 95%

Delphi consensus statement on intrapartum fetal monitoring in low‐resource settings

Housseine

Punt

Browne

et al. 2018

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To determine acceptable and achievable strategies of intrapartum fetal monitoring in busy low‐resource settings. Methods Three rounds of online Delphi surveys were conducted between January 1 and October 31, 2017. International experts with experience in low‐resource settings scored the importance of intrapartum fetal monitoring methods. Results 71 experts completed all three rounds (28 midwives, 43 obstetricians). Consensus was reached on (1) need for an admission test, (2) handheld Doppler for intrapartum fetal monitoring, (3) intermittent auscultation (IA) every 30 minutes for low‐risk pregnancies during the first stage of labor and after every contraction for high‐risk pregnancies in the second stage, (4) contraction monitoring hourly for low‐risk pregnancies in the first stage, and (5) adjunctive tests. Consensus was not reached on frequency of IA or contraction monitoring for high‐risk women in the first stage or low‐risk women in the second stage of labor. Conclusion There is a gap between international recommendations and what is physically possible in many labor wards in low‐resource settings. Research on how to effectively implement the consensus on fetal assessment at admission and use of handheld Doppler during labor and delivery is crucial to support staff in achieving the best possible care in low‐resource settings.

show abstract

Section: Discussionmentioning

confidence: 95%

Delphi consensus statement on intrapartum fetal monitoring in low‐resource settings

Housseine

Punt

Browne

et al. 2018

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…Vacuum extraction was indeed safer for the mother : risk of severe maternal complications (maternal death, uterine rupture while waiting for procedure, hysterectomy and re‐laparotomy) was 0.8% (3/358) in women who had had (trial of) vacuum extraction as compared to 4.2% (18/425) in women who had undergone second stage CS. During or after CS 5/425 (1.2%) of women died, none (0/358) after (trial of) vacuum extraction .…”

Section: Discussionmentioning

confidence: 98%

“…Occurrence of perinatal death was 45/410 (11.0%) in the CS group and 29/347 (8.4%) in the vacuum extraction group ( P = 0.227). Occurrence of intra uterine foetal death during waiting time for CS was 18/410 (4.4%) and for vacuum extraction 3/347 (0.9%, P = 0.003) .…”

Section: Discussionmentioning

confidence: 99%

Women's recommendations: vacuum extraction or caesarean section for prolonged second stage of labour, a prospective cohort study in Uganda

Nolens

Akker

Lule

et al. 2019

Tropical Med Int Health

Self Cite

View full text Add to dashboard Cite

Objectives To investigate what women who have experienced vacuum extraction or second stage caesarean section (CS) would recommend as mode of birth in case of prolonged second stage of labour. Methods A prospective cohort study was conducted in a tertiary referral hospital in Uganda. Between November 2014 and July 2015, women with a term singleton in vertex presentation who had undergone vacuum extraction or second stage CS were included. The first day and 6 months after birth women were asked what they would recommend to a friend: vacuum extraction or CS and why. Outcome measures were: proportions of women choosing vacuum extraction vs. CS and reasons for choosing this mode of birth. Results The first day after birth, 293/318 (92.1%) women who had undergone vacuum extraction and 176/409 (43.0%) women who had undergone CS recommended vacuum extraction. Of women who had given birth by CS in a previous pregnancy and had vacuum extraction this time, 31/32 (96.9%) recommended vacuum extraction. Six months after birth findings were comparable. Less pain, shorter recovery period, avoiding surgery and the presumed relative safety of vacuum extraction to the mother were the main reasons for preferring vacuum extraction. Main reasons to opt for CS were having experienced CS without problems, CS presumed as being safer for the neonate, CS being the only option the woman was aware of, as well as the concern that vacuum extraction would fail. Conclusions Most women would recommend vacuum extraction over CS in case of prolonged second stage of labour.

show abstract

“…It may already be almost impossible in most LMICs, given the lack of time and skilled birth attendants. The road to prevention of intrapartum stillbirths is likely to be a long one, but the two aforementioned papers represent a vital step, along with an emphasis on the re‐introduction of vaginal instrumental deliveries in many LICs, as shown in a 2018 paper published in IJGO …”

mentioning

confidence: 99%

“…The road to prevention of intrapartum stillbirths is likely to be a long one, but the two aforementioned papers represent a vital step, along with an emphasis on the re-introduction of vaginal instrumental deliveries in many LICs, as shown in a 2018 paper published in IJGO. 5 Affordable and low-maintenance obstetric devices are essential in LMICs. The devices, as showcased in the paper published in this issue, 6 may help practitioners to choose the appropriate instruments for the relevant procedures.…”

mentioning

confidence: 99%

Framework for safe delivery: A call to action

Visser

Stones

Nassar

et al. 2019

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Prospective cohort study comparing outcomes between vacuum extraction and second‐stage cesarean delivery at a Ugandan tertiary referral hospital

Abstract: Vacuum extraction had better maternal outcomes and equivalent perinatal outcomes compared with SSCD. These findings encourage re-introduction of vacuum extraction.

Cited by 28 publications

References 24 publications

Delphi consensus statement on intrapartum fetal monitoring in low‐resource settings

Delphi consensus statement on intrapartum fetal monitoring in low‐resource settings

Women's recommendations: vacuum extraction or caesarean section for prolonged second stage of labour, a prospective cohort study in Uganda

Framework for safe delivery: A call to action

Contact Info

Product

Resources

About