Ventouse Kiwi® versus forceps et spatules : évaluation de la morbidité maternelle et fœtale. À propos de 169 cas

Werkoff, G.; Morel, Olivier; Desfeux, P.; Gayat, Étienne; Akerman, G.; Tulpin, L.; Malartic, C.; Barranger, Emmanuel

doi:10.1016/j.gyobfe.2010.08.009

Cited by 7 publications

(3 citation statements)

References 15 publications

(26 reference statements)

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“…Contradictory data have been published about whether differences exist in the failure rate between each procedure. Some authors have found a greater number of cup detachments (41.7%-44%) 15,16 and a significantly higher failure rate (30.1%-44%) [15][16][17][18] with the Kiwi. However, other authors have not shown these differences in failure rates and have found success rates between 94%-100% in both groups.…”

Section: Discussionmentioning

confidence: 99%

Are there differences in the damage to the pelvic floor between malmstrom's and kiwi omnicup vacuums? A multicenter study

González-Díaz

García‐Mejido

Martín‐Martinez

et al. 2019

Neurourology and Urodynamics

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Objectives: The objective of this study is to investigate a multicenter study to establish if differences exist in the levator ani muscle avulsion (LAM) rates between deliveries performed with Malmstrom's vacuum and the Kiwi vacuum. Study design:A prospective, multicenter observational study with 199 primiparous subjects was performed. All patients had undergone vaginal delivery by vacuum (Malmstrom's or Kiwi). Avulsion was defined as an abnormal insertion of LAM in the lower pubic branch in the multiplanar mode, as identified in the three central sections by transperineal 3/4D echography 6 months after delivery. The area of the levator hiatus was measured in the plane of minimum dimensions at rest, during the Valsalva maneuver and during contraction.Results: LAM avulsion occurred in 33.1% of cases in which Malmstrom's vacuum was used and in 29.4% of cases in which the Kiwi vacuum was used (the difference was not statistically significant), which resulted in a crude odds ratio (OR) of 0.977 (0.426, 2.241; P = .957) and an adjusted OR of 2.90 (0.691; 12.20; P = .146). Women in the Malmstrom's vacuum group had a larger LHA at rest 14.77 vs 12.64 cm 2 ; P = .001) and at maximum contraction (13.41 vs 10.83 cm 2 ; P < 0.001) in comparison with the Kiwi group, although the difference did not reach statistical significance under Valsalva maneuver (18.71 vs 17.21 cm 2 ; P = .051).Differences between both groups were detected in the measurements of the hiatus area levator at rest (14.77 vs 12.64 cm 2 ), during the Valsalva maneuver (18.71 vs 17.21 cm 2 ) and during maximum contraction (13.41 vs 10.83 cm 2 ). Conclusions:In the present study, Malmstrom's vacuum was not associated with a higher risk of LAM in comparison with Kiwi's Omnicup. K E Y W O R D Skiwi omnicup vacuum, levator ani muscle, malmstrom's vacuum, pelvic floor, ultrasound

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Section: Discussionmentioning

confidence: 99%

Are there differences in the damage to the pelvic floor between malmstrom's and kiwi omnicup vacuums? A multicenter study

González-Díaz

García‐Mejido

Martín‐Martinez

et al. 2019

Neurourology and Urodynamics

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“…The association between PPH and instrumental delivery has already been reported in the literature, in particular for the use of forceps[ 1 , 25 – 28 ]. In addition, the use of forceps has been associated with a greater risk of PPH than vacuum extraction[ 29 ]. We did not see an increased risk of PPH associated with vacuum extraction, but we found a significant association between PPH and forceps.…”

Section: Discussionmentioning

confidence: 99%

Duration of Expulsive Efforts and Risk of Postpartum Hemorrhage in Nulliparous Women: A Population-Based Study

et al. 2015

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ObjectiveTo assess the specific association between the duration of expulsive efforts and the risk of postpartum hemorrhage.MethodsPopulation-based cohort-nested case-control study of nulliparous women delivering vaginally in 106 French maternity units between December 2004 and November 2006, including 3,852 women with PPH (blood loss ≥ 500 mL and/or peripartum Hb decrease ≥ 2 g/dL), 1,048 of them severe (peripartum Hb decrease ≥ 4 g/dL or transfusion of ≥ 2 units of red blood cells), and 762 controls from a representative sample of deliveries without hemorrhage in the same population. The association between duration of expulsive efforts and postpartum hemorrhage was estimated by multilevel logistic regression models adjusted for individual and hospital characteristics.ResultsMedian duration of expulsive efforts was 18 minutes among controls, 20 minutes among postpartum hemorrhage and 23 minutes among severe postpartum hemorrhage (p<0.01). Duration of expulsive efforts was significantly, positively, and linearly associated with both postpartum hemorrhage and severe postpartum hemorrhage. After adjustment for other risk factors, every additional 10 minutes of expulsive efforts was associated with about a 10% increase in the risk of postpartum hemorrhage (aOR = 1.11 [1.02–1.21]) and severe postpartum hemorrhage (aOR = 1.14 [1.03–1.27]). Oxytocin during labor, duration of active phase of labor, forceps use, episiotomy, perineal tears, and birth weight were also independently associated with both risks.ConclusionDuration of expulsive efforts was independently associated with postpartum hemorrhage and severe postpartum hemorrhage. Interventions to shorten the duration of this stage, such as oxytocin, forceps, and episiotomy, are also associated with higher risks of postpartum hemorrhage. Beyond duration, other aspects of the management of active second stage should be evaluated as some might allow it to last longer with a minimal increase in postpartum hemorrhage risk.

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“…They also were limited by methodologic flaws including small sample size, retrospective design, limited data quality and availability, and absence of propensity score analysis to limit the indication bias affecting choice of instrument. 4,[34][35][36][37][38] Any statistical approaches were limited to multivariable analyses controlling for some potential confounders. In these cases, results were consistent with our adjusted OR showing higher maternal morbidity with forceps-assisted delivery than with vacuum-assisted delivery.…”

Section: Discussionmentioning

confidence: 99%

Maternal and Neonatal Morbidity After Attempted Operative Vaginal Delivery

Froeliger

Mattuizzi

Madar

et al. 2022

Obstetrics &Amp; Gynecology

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BMI, body mass index; PPH, postpartum hemorrhage; ACOG, American College of Obstetricians and Gynecologists; FHR, fetal heart rate. Data are mean6SD, n (%), or median (interquartile range) unless otherwise specified. * Student's t, x 2 , Kruskal-Wallis, and Fisher exact tests were used as appropriate. P5.05 was considered significant. † Fundal height measurement at delivery greater than 37 cm or ultrasonographic fetal abdominal circumference greater than the 90 th percentile for gestational age on Hadlock curves.

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Ventouse Kiwi® versus forceps et spatules : évaluation de la morbidité maternelle et fœtale. À propos de 169 cas

Cited by 7 publications

References 15 publications

Are there differences in the damage to the pelvic floor between malmstrom's and kiwi omnicup vacuums? A multicenter study

Are there differences in the damage to the pelvic floor between malmstrom's and kiwi omnicup vacuums? A multicenter study

Duration of Expulsive Efforts and Risk of Postpartum Hemorrhage in Nulliparous Women: A Population-Based Study

Maternal and Neonatal Morbidity After Attempted Operative Vaginal Delivery

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