Time from Uterine Incision to Delivery and Hypoxic Neonatal Outcomes

Spain, Janine E.; Tuuli, Methodius G.; Stout, Molly J.; Roehl, Kimberly A.; Odibo, Anthony O.; Macones, George A.; Cahill, Alison G.

doi:10.1055/s-0034-1396696

Cited by 8 publications

(12 citation statements)

References 7 publications

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“…[8][9][10] A shorter U-D interval is desirable, since it is associated with improved maternal and fetal outcomes and fewer complications. [12,13] The findings of this study refute an older study and one case report that suggested that vacuumassisted caesarean section results in longer times to delivery. [5,14] The secondary aim was to examine whether there were differences in perioperative complications in the mother and fetus when comparing the CaesAid VAD cup with forceps.…”

Section: Discussioncontrasting

confidence: 64%

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An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section

Stolwijk

Jong

2019

S Afr J OG

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Background. Vacuum-assisted caesarean delivery may result in a quicker delivery of the fetal head than the use of forceps, and improve maternal and fetal outcomes. The new CaesAid vacuum-assisted delivery (VAD) cup was designed specifically for this use. Objectives. To assess whether the CaesAid VAD cup influences the duration of fetal head delivery at caesarean section when compared with forceps, and whether there are differences in perioperative complications in the mother and fetus. Methods. We carried out a retrospective clinical audit of 132 patients who underwent caesarean delivery at the Netcare Christiaan Barnard Memorial Hospital in Cape Town, South Africa, from April to November 2017, aided by either CaesAid VAD cup (C group, n=67) or forceps (F group, n=65). Results. The uterine incision-to-delivery interval was significantly shorter (p=0.001) in the C group than the F group (median 38 (interquartile range (IQR) 20) v. 60 (IQR 50) seconds, respectively). The maternal blood loss was lower in the C group than the F group (250 mL v. 288 mL; p=0.025). There was no significant difference in Apgar scores or admissions to the neonatal intensive care unit. Neonatal skin injuries were less common in the C group (no cases v. 8 in the F group; p=0.004). Conclusion. The results of this audit suggest that the CaesAid VAD cup is a safe and efficient alternative to forceps for aiding the delivery of the fetal head at caesarean section. However, the routine use of vacuum cups is debatable. Further research could provide more insight into this procedure as a part of obstetric practice.

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Section: Discussioncontrasting

confidence: 64%

“…Increased time to delivery of the fetal head is associated with compromised maternal and fetal outcomes and more complications. [12,13] The secondary objective was to assess whether there was a difference in perioperative complications in the mother and fetus between the two methods of delivery.…”

mentioning

confidence: 99%

An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section

Stolwijk

Jong

2019

S Afr J OG

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“…7 In addition, higher order cesarean delivery is associated with an increased operative time. 6,10,13,14 While evidence is mixed regarding neonatal effects of prolonged operative time, a longer incision to delivery interval has been associated with an increased frequency of neonatal hypoxic morbidity. 14–15 An unscheduled presentation due to labor only serves to compound these risks.…”

mentioning

confidence: 99%

Optimal Timing of Delivery in Women with Higher Order Cesareans: A Cohort Study

2018

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“…According to the literature, there does not appear to be any significant difference in hypoxic morbidity with increasing increments of the uterine incision to delivery time of non-anomalous term neonates. 14 For the non-reassuring fetal status, if the delivery time of the fetal head exceeds 240 s, the incidence of neonatal asphyxia significantly increases (relative risk, 5.58; 95% confidence interval: 1.30–23.91). 15 In clinical practice, delivering the fetus within 3 minutes is difficult, especially for a fetus with a head deep in the pelvis, which is more challenging for inexperienced physicians.…”

Section: Discussionmentioning

confidence: 99%

Complete cervical inversion and nearly inappropriate stitching with cesarean section during the second stage of labor: a case report

2021

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Cesarean section is a common obstetric operation and an important method for saving the lives of mothers and their neonates in dangerous situations. Nevertheless, cesarean section has a higher risk and might have more complications compared with natural delivery. A reasonable choice of delivery method is important for maternal and neonatal health. The incidence of complications after cesarean section for mothers and neonates during the second stage of labor significantly increases compared with planned cesarean section. During the second stage of labor, the fetal head is deep in the pelvic cavity. If a cesarean section is performed at this stage, it is prone to causing complications, including difficult delivery of the fetal head, delayed uterine incision, and massive hemorrhage, which seriously threaten the health of the mother and her neonate. For the first time, we report a case of cesarean section after complete opening of the uterine orifice, which led to almost mistakenly suturing the cervix to the uterus. This report will hopefully help surgeons anticipate such incidents during cesarean section in the future.

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Time from Uterine Incision to Delivery and Hypoxic Neonatal Outcomes

Abstract: Overall, duration from uterine incision to delivery for in-labor cesareans of nonanomalous term infants was not associated with an increase in risk of hypoxia-associated morbidities.

Cited by 8 publications

References 7 publications

An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section

An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section

Optimal Timing of Delivery in Women with Higher Order Cesareans: A Cohort Study

Complete cervical inversion and nearly inappropriate stitching with cesarean section during the second stage of labor: a case report

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