Vacuum‐assisted delivery: An analysis of traction force and maternal and neonatal outcomes

Vacca, Aldo

doi:10.1111/j.1479-828x.2006.00540.x

Cited by 55 publications

(56 citation statements)

References 10 publications

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“…21 In a study by Vacca A. et al, among 119 attempted vacuum deliveries, there were 80% of nullipara and their neonates were delivered safely with vacuum extractor. 22 In our study, the principal cause of maternal morbidity was genital tract injuries in 6.7% followed by primary PPH in 3.8% which is similar to findings in the study by Hafeez 18,20,21 The fetal morbidities like cephalohematoma due to vacuum extractor has good fetal outcome with its subsidence in a few days. Birth asphyxia with vacuum application is primarily due to the result of prolonged second stage rather than vacuum use.…”

Section: Discussionsupporting

confidence: 89%

“…7,19 Compared to other studies, our neonates had lesser number of cephalohematoma; 4.84% (n=5) versus 10.4% (n=7) in a study by Hafeez et al, 18% (n=38) in another study by Yakasai et al 7,16 Our study had similar results to that of Giri et al (3% cephalohematoma, 20% birth asphyxia) and Vacca A. et al (8.4% cephalohematoma). 18,22 Our result had similar rate of neonatal morbidity (25%) compared to that of Hafeez et al (22.1%) and less morbidity compared to that of Yakasai et al (31%). 7,16 …”

Section: Discussionsupporting

confidence: 75%

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Vacuum Assisted Vaginal Delivery in Singleton Term Pregnancies: Short Term Maternal and Neonatal Outcome in a Tertiary Hospital of Nepal

Shrestha

Thapa

2016

J Lumbini Med Coll

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Introduction: Other than cesarean delivery, assisted vaginal delivery is an alternative procedure for delivery in emergency obstetrics. Presently, vacuum delivery has gained more popularity than forceps for operative/ assisted vaginal delivery, when and where indicated, with success as well as lesser neonatal and maternal complications. This study was done to estimate the short term maternal and fetal morbidity/mortality due to vacuum assisted vaginal delivery. Methods: A prospective observational study was conducted at Lumbini Medical College Teaching Hospital from January 2015 to May 2016. One hundred and four pregnant women who had successful vacuum assisted vaginal deliveries were enrolled. Fetal and maternal outcome were assessed. Results: One hundred and four successful vacuum deliveries (2.9%) were conducted among 3457 deliveries during our study period. Sixty seven (64.4%) were primigravida and most (n=59, 56.7%) parturients were of age group 20-30 years. The commonest (n=65, 62.5%) indication for vacuum application was prolonged second stage of labor. The maternal morbidity variables were: 6.7% (n=7) had genital tract injury, 3.8% (n=4) had primary post-partum hemorrhage, 3.8% (n=4) had urinary retention, 2.8% (n=3) needed blood transfusion. Among neonatal morbidity indicators, 19.2% (n=20) neonates had birth asphyxia, 4.8% (n=5) neonates had cephalohematoma, 0.96% (n=1) had brachial plexus injury. There was one early neonatal death due to meconium aspiration syndrome. Conclusion: A successful vacuum assisted delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labor, skilled operator, and availability of neonatal team.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 75%

Vacuum Assisted Vaginal Delivery in Singleton Term Pregnancies: Short Term Maternal and Neonatal Outcome in a Tertiary Hospital of Nepal

Shrestha

Thapa

2016

J Lumbini Med Coll

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“…However, there is no established definition of this moderate traction, neither in clinical practice nor in the literature, and observed levels of force vary between studies. Two studies on plastic cup extractions suggest that the majority of deliveries require no more than the force equivalent to 11,5 kg (approximately 112 Newton)[6, 7]. Our research group found a different result in an observational study of 200 metal cup extractions, with average peak traction forces of 176, 225 and 241 N, depending on subjective category as easy, average or strong extraction respectively[8].…”

Section: Introductionmentioning

confidence: 86%

Predictive value of traction force measurement in vacuum extraction: Development of a multivariate prognostic model

Pettersson¹,

Yousaf²,

Ranstam³

et al. 2017

PLoS ONE

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ObjectiveTo enable early prediction of strong traction force vacuum extraction.DesignObservational cohort.SettingKarolinska University Hospital delivery ward, tertiary unit.Population and sample sizeTerm mid and low metal cup vacuum extraction deliveries June 2012—February 2015, n = 277.MethodsTraction forces during vacuum extraction were collected prospectively using an intelligent handle. Levels of traction force were analysed pairwise by subjective category strong versus non-strong extraction, in order to define an objective predictive value for strong extraction.Statistical analysisA logistic regression model based on the shrinkage and selection method lasso was used to identify the predictive capacity of the different traction force variables.PredictorsTotal (time force integral, Newton minutes) and peak traction (Newton) force in the first to third pull; difference in traction force between the second and first pull, as well as the third and first pull respectively. Accumulated traction force at the second and third pull.OutcomeSubjectively categorized extraction as strong versus non-strong.ResultsThe prevalence of strong extraction was 26%. Prediction including the first and second pull: AUC 0,85 (CI 0,80–0,90); specificity 0,76; sensitivity 0,87; PPV 0,56; NPV 0,94. Prediction including the first to third pull: AUC 0,86 (CI 0,80–0,91); specificity 0,87; sensitivity 0,70; PPV 0,65; NPV 0,89.ConclusionTraction force measurement during vacuum extraction can help exclude strong category extraction from the second pull. From the third pull, two-thirds of strong extractions can be predicted.

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“…Cet indicateur mesure de manière fiable les forces imposées au cours de l'extraction [13]. L'application de forces supérieures à 13,5 kg pourrait augmenter les risques de survenue de complications maternelles et néonatales [14]. Ainsi, l'indicateur de traction pourrait permettre de mieux contrôler la force au cours du geste.…”

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Deruelle

Queste-Bothuyne

Depret

et al. 2007

Gynécologie Obstétrique & Fertilité

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Vacuum‐assisted delivery: An analysis of traction force and maternal and neonatal outcomes

Cited by 55 publications

References 10 publications

Vacuum Assisted Vaginal Delivery in Singleton Term Pregnancies: Short Term Maternal and Neonatal Outcome in a Tertiary Hospital of Nepal

Vacuum Assisted Vaginal Delivery in Singleton Term Pregnancies: Short Term Maternal and Neonatal Outcome in a Tertiary Hospital of Nepal

Predictive value of traction force measurement in vacuum extraction: Development of a multivariate prognostic model

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