Risk factors associated with subgaleal hemorrhage in neonates exposed to vacuum extraction.
Adult
Analysis of Variance
Case-Control Studies
Female
Gestational Age
Hospitals, University
Humans
Infant, Newborn
Israel
Labor Stage, Second
Logistic Models
Obstetric Labor Complications
/ diagnosis
Pregnancy
Prognosis
ROC Curve
Retrospective Studies
Risk Assessment
Subarachnoid Hemorrhage
/ diagnostic imaging
Survival Rate
Vacuum Extraction, Obstetrical
/ adverse effects
Young Adult
morbidity
operative vaginal delivery
outcomes
subgaleal hemorrhage
vacuum-assisted delivery
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
21
03
2019
accepted:
14
06
2019
pubmed:
21
6
2019
medline:
1
4
2020
entrez:
21
6
2019
Statut:
ppublish
Résumé
Subgaleal hemorrhage (SGH) is a life-threatening neonatal condition that is strongly associated with vacuum assisted delivery (VAD). The factors associated with the development of SGH following VAD are not well-established. We aimed to evaluate the factors associated with the development of SGH following attempted VAD. A retrospective case-control study of women who delivered at a tertiary university-affiliated medical center in Jerusalem, Israel, during 2009-2018. Cases comprised all parturients with singleton pregnancies for whom attempted VAD resulted in neonatal SGH. A control group of VAD attempts was established by matching one-to-one according to gestational age at delivery, parity and year of delivery. Fetal, intrapartum and vacuum procedure characteristics were compared between the groups. In all, 313 (89.5%) of the 350 attempted VAD were nulliparous. Baseline maternal and fetal characteristics were similar between the groups except for higher neonatal birthweight in the SGH group. In multivariate logistic regression analysis, only six independent risk factors were significantly associated with the development of SGH: second-stage duration (for each 30-minute increase, adjusted odds ratio [OR] 1.13; 95% confidence intervals [CI] 1.04-1.25; P = .006), presence of meconium-stained amniotic fluid (adjusted OR 2.61; 95% CI 1.52-4.48; P = .001), presence of caput succedaneum (adjusted OR 1.79; 95% CI 1.11-2.88; P = .01), duration of VAD (for each 3-minute increase, adjusted OR 2.04; 95% CI 1.72, 2.38; P < .001), number of dislodgments (adjusted OR 2.38; 95% CI 1.66-3.44; P < .001), and fetal head station (adjusted OR 3.57; 95% CI 1.42-8.33; P = .006). Receiver operating characteristic curves showed that VAD duration of ≥15 minutes had a 96.7% sensitivity and 75.0% specificity in predicting SGH formation, with an area under the curve equal to .849. Vacuum duration, the number of dislodgments, the duration of second stage of delivery, fetal head station, the presence of caput succedaneum and the presence of meconium were found to be independently associated with SGH formation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1464-1472Informations de copyright
© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.
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