Vacuum extraction or caesarean section in the second stage of labour: A systematic review.
caesarean section
maternal
morbidity
mortality
neonatal
operative vaginal delivery
perinatal
vacuum extraction
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
27
11
2022
received:
20
06
2022
accepted:
07
12
2022
medline:
14
4
2023
pubmed:
21
1
2023
entrez:
20
1
2023
Statut:
ppublish
Résumé
Prolonged second stage of labour is an important cause of maternal and perinatal morbidity and mortality. Vacuum extraction (VE) and second-stage caesarean section (SSCS) are the most commonly performed obstetric interventions, but the procedure chosen varies widely globally. To compare maternal and perinatal morbidity, mortality and other adverse outcomes after VE versus SSCS. A systematic search was conducted in PubMed, Cochrane and EMBASE. Studies were critically appraised using the Newcastle-Ottawa scale. All artictles including women in second stage of labour, giving birth by vacuum extraction or cesarean section and registering at least one perinatal or maternal outcome were selected. The chi-square test, Fisher exact's test and binary logistic regression were used and various adverse outcome scores were calculated to evaluate maternal and perinatal outcomes. Fifteen articles were included, providing the outcomes for a total of 20 051 births by SSCS and 32 823 births by VE. All five maternal deaths resulted from complications of anaesthesia during SSCS. In total, 133 perinatal deaths occurred in all studies combined: 92/20 051 (0.45%) in the SSCS group and 41/32 823 (0.12%) in the VE group. In studies with more than one perinatal death, both conducted in low-resource settings, more perinatal deaths occurred during the decision-to-birth interval in the SSCS group than in the VE group (5.5% vs 1.4%, OR 4.00, 95% CI 1.17-13.70; 11% vs 8.4%, OR 1.39, 95% CI 0.85-2.26). All other adverse maternal and perinatal outcomes showed no statistically significant differences. Vacuum extraction should be the recommended mode of birth, both in high-income countries and in low- and middle-income countries, to prevent unnecessary SSCS and to reduce perinatal and maternal deaths when safe anaesthesia and surgery is not immediately available.
Sections du résumé
BACKGROUND
Prolonged second stage of labour is an important cause of maternal and perinatal morbidity and mortality. Vacuum extraction (VE) and second-stage caesarean section (SSCS) are the most commonly performed obstetric interventions, but the procedure chosen varies widely globally.
OBJECTIVES
To compare maternal and perinatal morbidity, mortality and other adverse outcomes after VE versus SSCS.
SEARCH STRATEGY
A systematic search was conducted in PubMed, Cochrane and EMBASE. Studies were critically appraised using the Newcastle-Ottawa scale.
SELECTION CRITERIA
All artictles including women in second stage of labour, giving birth by vacuum extraction or cesarean section and registering at least one perinatal or maternal outcome were selected.
DATA COLLECTION AND ANALYSIS
The chi-square test, Fisher exact's test and binary logistic regression were used and various adverse outcome scores were calculated to evaluate maternal and perinatal outcomes.
MAIN RESULTS
Fifteen articles were included, providing the outcomes for a total of 20 051 births by SSCS and 32 823 births by VE. All five maternal deaths resulted from complications of anaesthesia during SSCS. In total, 133 perinatal deaths occurred in all studies combined: 92/20 051 (0.45%) in the SSCS group and 41/32 823 (0.12%) in the VE group. In studies with more than one perinatal death, both conducted in low-resource settings, more perinatal deaths occurred during the decision-to-birth interval in the SSCS group than in the VE group (5.5% vs 1.4%, OR 4.00, 95% CI 1.17-13.70; 11% vs 8.4%, OR 1.39, 95% CI 0.85-2.26). All other adverse maternal and perinatal outcomes showed no statistically significant differences.
CONCLUSIONS
Vacuum extraction should be the recommended mode of birth, both in high-income countries and in low- and middle-income countries, to prevent unnecessary SSCS and to reduce perinatal and maternal deaths when safe anaesthesia and surgery is not immediately available.
Identifiants
pubmed: 36660890
doi: 10.1111/1471-0528.17394
doi:
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
586-598Informations de copyright
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
Références
World Health Organization [Internet]. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. [cited 15 June 2022]. Available from: https://www.unfpa.org/featured-publication/trends-maternal-mortality-2000-2017
Wang H, Bhutta ZA, Coates MM, Coggeshall M, Dandona L, Diallo K, et al. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1725-74.
World Health Organization [Internet]. Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. World Health Organization. 2015 [Cited 15 June 2022]. Available from: https://www.unfpa.org/publications/trends-maternal-mortality-1990-2015
Kassebaum NJ, Barber RM, Bhutta ZA, Dandona L, Gething PW, Hay SI, et al. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden Of Disease Study 2015. Lancet. 2016;388(10053):1775-812.
Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ. 2007;335(7628):1025.
Wright A, Nassar AH, Visser G, Ramasauskaite D, Theron G, FIGO Safe Motherhood and Newborn Health Committee. FIGO good clinical practice paper: management of the second stage of labor. Int J Gynecol Obstet. 2021;152(2):172-81.
Nunes VD, Gholitabar M, Sims JM, Bewley S. Intrapartum care of healthy women and their babies: summary of updated NICE guidance. BMJ. 2014;349:g6886.
Caughey AB, Cahill AG, Guise JM, Rouse DJ, American College of Obstetricians and Gynecologists. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol. 2014;210(3):179-93.
O'Mahony F, Hofmeyr GJ, Menon V. Choice of instruments for assisted vaginal delivery. Cochrane Database Syst Rev. 2010;(11):CD005455.
Chalmers JA, Chalmers I. The obstetric vacuum extractor is the instrument of first choice for operative vaginal delivery. BJOG. 1989;96(5):505-6.
O'Mahony F, Hofmeyr GJ, Menon V. Choice of instruments for assisted vaginal delivery [Internet]. Cochrane database of systematic reviews. [updated 24 September 2021; cited 15 June 2022]. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005455.pub3/full
Johanson R, Menon V. Vacuum extraction versus forceps for assisted vaginal delivery [Internet]. Cochrane Database of Systematic Reviews. [updated at 10 November 2010, cites 15 June 2022]. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000224.pub2/full
Martin JA. Births: final data for 2010 [Internet]. National vital statistics reports. 2012; vol. 61(1). [cited 15 June 2022]. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_05.pdf
Anozie OB, Osaheni LL, Onu FA, Onoh RC, Ogah EO, Eze JN, et al. Declining rate of operative vaginal deliveries in Nigeria. Open J Obstet Gynecol. 2018;8(3):175-84.
Hirshberg A, Srinivas SK. Role of operative vaginal deliveries in prevention of cesarean deliveries. Clin Obstet Gynecol. 2015;58(2):256-62.
Bailey PE. The disappearing art of instrumental delivery: time to reverse the trend. Int J Gynecol Obstet. 2005;91(1):89-96.
Bailey PE, van Roosmalen J, Mola G, Evans C, de Bernis L, Dao B. Assisted vaginal delivery in low and middle income countries: an overview. BJOG. 2017;124(9):1335-44.
Magann EF, Evans S, Hutchinson M, Collins R, Lanneau G, Morrison JC. Postpartum hemorrhage after cesarean delivery: an analysis of risk factors. South Med J. 2005;98(7):681-6.
Fawcus S, Moodley J. Postpartum haemorhage associated with caesarean section and caesarean hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2013;27(2):233-49.
Zuarez-Easton S, Zafran N, Garmi G, Salim R. Postcesarean wound infection: prevalence, impact, prevention, and management challenges. Int J Womens Health. 2017;9:81-8.
Zwart JJ, Richters JM, Öry F, De Vries JI, Bloemenkamp KW, Van Roosmalen J. Uterine rupture in The Netherlands: a nationwide population-based cohort study. BJOG. 2009;116(8):1069-80.
Yang Q, Wen SW, Oppenheimer L, Chen XK, Black D, Gao J, et al. Association of caesarean delivery for first birth with placenta praevia and placental abruption in second pregnancy. BJOG. 2007;114(5):609-13.
Wood SL, Tang S, Crawford S. Cesarean delivery in the second stage of labor and the risk of subsequent premature birth. Am J Obstet Gynecol. 2017;217(1):63.e1-63.e10.
Boerma T, Ronsmans C, Melesse DY, Barros AJ, Barros FC, Juan L, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018;392(10155):1341-8.
Prisma statement [Internet]. [cited 15 June 2022]. Available from: http://www.prisma-statement.org/
Ottawa: Ottawa Hospital Research Institute. [Internet]. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. [cited 15 June 2022]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
Mann S, Pratt S, Gluck P, Nielsen P, Risser D, Greenberg P, et al. Assessing quality in obstetrical care: development of standardized measures. Jt Comm J Qual Patient Saf. 2006;32(9):497-505.
Bailit JL, Grobman WA, Rice MM, Wapner RJ, Reddy UM, Varner MW, et al. Evaluation of delivery options for second-stage events. Am J Obstet Gynecol. 2016 May 1;214(5):638-e1.
Contag SA, Clifton RG, Bloom SL, Spong CY, Varner MW, Rouse DJ, et al. Neonatal outcomes and operative vaginal delivery versus cesarean delivery. Am J Perinatol. 2010;27(6):493-9.
Eze P, Lawani LO, Chikezie RU, Ukaegbe CI, Iyoke CA. Perinatal outcomes of babies delivered by second-stage caesarean section versus vacuum extraction in a resource-poor setting, Nigeria-a retrospective analysis. BMC Pregnancy Childbirth. 2020;20:298.
Giacchino T, Karkia R, Zhang W, Beta J, Ahmed H, Akolekar R. Kielland's rotational forceps delivery: a comparison of maternal and neonatal outcomes with rotational ventouse or second stage caesarean section deliveries. Eur J Obstet Gynecol Reprod Biol. 2020;254:175-80.
Gurney L, Al Wattar BH, Sher A, Echevarria C, Simpson H. Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres: a retrospective observational study. BJOG. 2021;128(7):1248-55.
Halscott TL, Reddy UM, Landy HJ, Ramsey PS, Iqbal SN, Huang CC, et al. Maternal and neonatal outcomes by attempted mode of operative delivery from a low station in the second stage of labor. Obstet Gynecol. 2015;126(6):1265-72.
Hendler I, Kirshenbaum M, Barg M, Kees S, Mazaki-Tovi S, Moran O, et al. Choosing between bad, worse and worst: what is the preferred mode of delivery for failure of the second stage of labor? J Matern Fetal Neonatal Med. 2017;30(15):1861-4.
Kessous R, Tirosh D, Weintraub AY, Benshalom-Tirosh N, Sergienko R, Sheiner E. Second stage disorders in patients following a previous cesarean section: vacuum versus repeated cesarean section. Arch Gynecol Obstet. 2013;287(6):1075-9.
Krizman E, Grzebielski P, Antony KM, Sampene E, Shanahan M, Iruretagoyena JI, et al. Operative vaginal delivery is a safe option in women undergoing a trial of labor after cesarean. Am J Perinatol Rep. 2019;9(2):e190-4.
Levin G, Rottenstreich A, Cahan T, Mankuta D, Yagel S, Yinon Y, et al. Second stage expedite delivery of low birth weight neonates: emergent cesarean delivery versus vacuum assisted delivery. J Gynecol Obstet Hum Reprod. 2021;50(8):102136.
Muraca GM, Sabr Y, Lisonkova S, Skoll A, Brant R, Cundiff GW, et al. Morbidity and mortality associated with forceps and vacuum delivery at outlet, low, and midpelvic station. J Obstet Gynaecol Can. 2019;41(3):327-37.
Nolens B, Namiiro F, Lule J, van den Akker T, van Roosmalen J, Byamugisha J. Prospective cohort study comparing outcomes between vacuum extraction and second-stage cesarean delivery at a Ugandan tertiary referral hospital. Int J Gynecol Obstet. 2018;142(1):28-36.
Polkowski M, Kuehnle E, Schippert C, Kundu S, Hillemanns P, Staboulidou I. Neonatal and maternal short-term outcome parameters in instrument-assisted vaginal delivery compared to second stage cesarean section in labour: a retrospective 11-year analysis. Gynecol Obstet Invest. 2018;83(1):90-8.
Shmueli A, Salman L, Ashwal E, Hiersch L, Gabbay-Benziv R, Yogev Y, et al. Perinatal outcomes of vacuum assisted versus cesarean deliveries for prolonged second stage of delivery at term. J Matern Fetal Neonatal Med. 2017;30(8):886-9.
Tempest N, Hart A, Walkinshaw S, Hapangama DK. A re-evaluation of the role of rotational forceps: retrospective comparison of maternal and perinatal outcomes following different methods of birth for malposition in the second stage of labour. BJOG. 2013;120(10):1277-84.
Sobhy S, Arroyo-Manzano D, Murugesu N, Karthikeyan G, Kumar V, Kaur I, et al. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis. Lancet. 2019;393(10184):1973-82.
Maaløe N, Housseine N, Bygbjerg IC, Meguid T, Khamis RS, Mohamed AG, et al. Stillbirths and quality of care during labour at the low resource referral hospital of Zanzibar: a case-control study. BMC Pregnancy Childbirth. 2016;16(1):351.
Mishra N, Gupta R, Singh N. Decision delivery interval in emergency and urgent caesarean sections: need to reconsider the recommendations? J Obstet Gynaecol India. 2018;68(1):20-6.
Hirani BA, Mchome BL, Mazuguni NS, Mahande MJ. The decision delivery interval in emergency caesarean section and its associated maternal and fetal outcomes at a referral hospital in northern Tanzania: a cross-sectional study. BMC Pregnancy Childbirth. 2017;17(1):411.
Raassen TJ, Ngongo CJ, Mahendeka MM. Iatrogenic genitourinary fistula: an 18-year retrospective review of 805 injuries. Int Urogynecol J. 2014;25(12):1699-706.
Tasnim N, Bangash K, Amin O, Luqman S, Hina H. Rising trends in iatrogenic urogenital fistula: a new challenge. Int J Gynecol Obstet. 2020;148:33-6.
Abrams M, Pope R. Obstetric and gynecologic genitourinary fistulas. Clin Obstet Gynecol. 2021;64(2):321-30.
Capelle M, Nolens B, Lule J, Byamugisha J, van Roosmalen J, van den Akker T. Health workers' perspectives on vacuum extraction in Mulago Hospital, Uganda. [cited 2023 Jan 31]. Available from: https://assets.researchsquare.com/files/rs-33627/v2/9619ab05-ccbc-4d8c-b2c1-d0029170a47c.pdf?c=165366
Simonson C, Barlow P, Dehennin N, Sphel M, Toppet V, Murillo D, et al. Neonatal complications of vacuum-assisted delivery. Obstet Gynecol. 2007;109(3):626-33.
Vacca A. Vacuum-assisted delivery. Best Pract Res Clin Obstet Gynaecol. 2002;16(1):17-30.
Wright A, Nassar AH, Visser G, Ramasauskaite D, Theron G, FIGO Safe Motherhood and Newborn Health Committee. FIGO good clinical practice paper: management of the second stage of labor. Int J Gynecol Obstet. 2021;152(2):172-81.
Nolens B, van den Akker T, Lule J, Twinomuhangi S, van Roosmalen J, Byamugisha J. Birthing experience and quality of life after vacuum delivery and second-stage caesarean section: a prospective cohort study in Uganda. Trop Med Int Health. 2018;23(8):914-22.
Declercq E, Cunningham D, Johnson C, Sakala C. Mothers' reports of postpartum pain associated with vaginal and caesarean deliveries: results of a national survey. Birth. 2008;35:16-24.
Carlander AKK, Andolf E, Edman G, Wiklund I. Health-related quality of life five years after birth of the first child. Sex Reprod Healthc. 2015;6:101-7.