What to do after a failed attempt of vacuum delivery?

Objectives: To determine whether there is a difference in maternal and neonatal outcomes if a sequential operative vaginal or cesarean delivery follows failed vacuum delivery. Study design: A cross sectional study. We have analyzed maternal and neonatal outcomes of 215 vacuum extractions (group 1),...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2003-04, Vol.107 (2), p.151-155
Main Authors: Sadan, Oscar, Ginath, Shimon, Gomel, Andrei, Abramov, Dora, Rotmensch, Sigi, Boaz, Mona, Glezerman, Marek
Format: Article
Language:English
Subjects:
Adult
Amniotic Fluid
Anemia - epidemiology
Apgar Score
Biological and medical sciences
Cesarean Section
Cross-Sectional Studies
Delivery, Obstetric - methods
Delivery. Postpartum. Lactation
Disorders
Dystocia - epidemiology
Failed vacuum/forceps delivery
Female
Fetal Distress
Forceps
Gynecology. Andrology. Obstetrics
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Labor Stage, Second
Length of Stay
Meconium
Medical sciences
Obstetrical Forceps
Obstetrical techniques
Pregnancy
Pregnancy Outcome
Respiratory Distress Syndrome, Newborn - epidemiology
Sequential/combined delivery
Shoulder
Time Factors
Treatment Failure
Vacuum
Vacuum Extraction, Obstetrical
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Summary:Objectives: To determine whether there is a difference in maternal and neonatal outcomes if a sequential operative vaginal or cesarean delivery follows failed vacuum delivery. Study design: A cross sectional study. We have analyzed maternal and neonatal outcomes of 215 vacuum extractions (group 1), 106 forceps assisted deliveries (group 2), 28 deliveries in which failed vacuum extraction were followed by forceps delivery (group 3) and 22 deliveries in which failed vacuum extraction were followed by cesarean delivery (group 4). Results: Compared to other groups, patients in group 4 had significantly more post partum anemia, meconium stained amniotic fluid and hospital stay (both maternal and neonatal) as well as lower pH. Apgar scores were similar in groups 3 and 4. Incidence of respiratory distress syndrome, cephalhematoma and jaundice were similar in neonates of all groups. Conclusions: If an attempted vacuum delivery has failed, the risk of adverse neonatal outcome is increased with either subsequent forceps or cesarean delivery. It should remain in the judgment of the attending obstetrician to choose the method most suitable under the given circumstances.
ISSN:0301-2115
1872-7654
DOI:10.1016/S0301-2115(02)00344-5