Association between the number of pulls and adverse neonatal/maternal outcomes in vacuum-assisted delivery.
Birth Injuries
/ epidemiology
Blood Transfusion
/ statistics & numerical data
Cohort Studies
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal
/ statistics & numerical data
Japan
/ epidemiology
Postpartum Hemorrhage
/ epidemiology
Pregnancy
Pregnancy Outcome
Retrospective Studies
Vacuum Extraction, Obstetrical
/ adverse effects
adverse outcome
neonatal intensive care unit
operative vaginal delivery
vacuum extraction
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
25 Jun 2021
25 Jun 2021
Historique:
received:
09
09
2020
accepted:
27
01
2021
pubmed:
19
2
2021
medline:
27
11
2021
entrez:
18
2
2021
Statut:
epublish
Résumé
To determine the association between the number of pulls during vacuum-assisted deliver and neonatal and maternal complications. This was a single-center observational study using a cohort of pregnancies who underwent vacuum-assisted delivery from 2013 to 2020. We excluded pregnancies transitioning to cesarean section after a failed attempt at vacuum-assisted delivery. The number of pulls to deliver the neonate was categorized into 1, 2, 3, and ≥4 pulls. We used logistic regression models to investigate the association between the number of pulls and neonatal intensive care unit (NICU) admission and maternal composite outcome (severe perineal laceration, cervical laceration, transfusion, and postpartum hemorrhage ≥500 mL). We extracted 480 vacuum-assisted deliveries among 7,321 vaginal deliveries. The proportion of pregnancies receiving 1, 2, 3, or ≥4 pulls were 51.9, 28.3, 10.8, and 9.0%, respectively. The crude prevalence of NICU admission with 1, 2, 3, and ≥4 pulls were 10.8, 16.2, 15.4, and 27.9%, respectively. The prevalence of NICU admission, amount of postpartum hemorrhage, and postpartum hemorrhage ≥500 mL were significantly different between the four groups. Multivariable logistic regression analysis found the prevalence of NICU admission in the ≥4 pulls group was significantly higher compared with the 1 pull group (adjusted odds ratio, 3.3; 95% confidence interval, 1.4-7.8). In contrast, maternal complications were not significantly associated with the number of pulls. Vacuum-assisted delivery with four or more pulls was significantly associated with an increased risk of NICU admission. However, the number of pulls was not associated with maternal complications.
Identifiants
pubmed: 33600672
pii: jpm-2020-0433
doi: 10.1515/jpm-2020-0433
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
583-589Informations de copyright
© 2021 Walter de Gruyter GmbH, Berlin/Boston.
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