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PubMed1990

Trends in caesarean section in Western Australia, 1980-1987.

During the 1980s the incidence of both emergency and elective caesarean section in Western Australia increased, accompanied by a decrease in that of all other delivery methods. The proportion of emergency caesarean sections increased from 5.9%. of all deliveries in 1980 to 8.2% in 1987 and that of elective sections from 5.3% to 8.7%. For each year studied less than 50% of primiparous women delivering singletons had a normal vaginal delivery. Emergency caesarean sections were more common in primiparas and at the teaching hospital and elective sections in multiparas and at the metropolitan private hospitals. The proportion of primiparas having either emergency or elective caesarean sections rose with maternal age, but for multiparas the proportion having elective sections rose, but there were few differences in emergency sections with increasing age. Repeat caesarean sections, which made up 28.8% of the total in 1987, have contributed increasingly to the rising proportion of caesarean section deliveries. Unless the number of emergency sections in primiparous women falls and the challenge of vaginal birth after caesarean section is met, it is likely that the caesarean section rate in Western Australia will continue to increase over the next decade.

Adult↗
PubMed2000

[Comparative assessment of efficacy and safety of assisted vaginal delivery with forceps and with vacuum extractor].

UNLABELLED: We performed a prospective, controlled, randomized trial to compare de safety and efficacy between the vaginal assisted delivery with vacum extractor forceps. We included a control group of primigravidae. We use the ACOG application criteria for operative obstetrics. We measured the differences in regard to indication for operative delivery, obstetric trauma and the general characteristics of the patients. A total of 210 patients were included which were distributed in three groups. In the first group we included the patients of vacum extractor, the second group of forceps and the third the control group. In our results we found no statistically significant differences among three groups in regard to the general characteristics and obstetric trauma. In the vacum extractor group we found six cefalohematomas (8.5%), two newborns with skin laceration (2.8%) and four newborns with cerebral edema (5.7%). In the forceps group we had two newborns diagnosed with cefalohematomas (2.8%), seven newborns with cerebral edema (10%) and scalp laceration on four newborns (6%). In the control group we found one cefalohematoma (1.4%) and cerebral edema in four newborns (5.7%). We did not find statistically significant differences when we compared the group of the vacum and the forceps. CONCLUSION: With this information we concluded that both instruments are equal in regard to efficacy and safety when they are use by experimented hands and following the application criteria. Nevertheless, there is a high incidence of vaginal injuries and obstetric trauma in the newborn in the operative delivery compared with the control group without an important increase in the perinatal mortality.

Adult↗
PubMed1973

Locked twins.

Explore the source record for details and available documents.

Adult↗
PubMed1991

A properly conducted trial of a ventouse can prevent unexpected failure of instrumental delivery.

A retrospective study over a 5-year period reviewed 71 unexpected failures of instrumental delivery and compared them with a group of 21 trials of ventouse to identify causes for failure and their impact on neonatal outcome. There was a statistically significant difference between the two groups in terms of pre-application assessment of fetal size, maternal pelvis and palpable fetal head above the pelvic brim (P less than 0.00001). There was also a significant difference in neonatal morbidity (P less than 0.01). All 5 neonatal deaths occurred in the failure group and were associated with multiple instrumentation.

Extraction, Obstetrical↗
PubMed1990

[Painless labor and instrumentation].

This report is a retrospective study of painless labor and its relation to the instrumentation. It consists of 200 cases of primigravida in labor. In the study group, 100 consecutive cases of primigravida receiving painless labor was chosen and compared to another 100 consecutive primigravida in labor without receiving painless labor. We found that painless labor with epidural analgesia would decrease the rate of cesarean section, but increase the frequency of using forceps and vacuum for labor. The rate of normal spontaneous delivery is low as compared with those not receiving epidural analgesia for painless labor. However, painless labor bears no relation to the labor course nor discernible significance to the Apgar Score of the newborn babies. We strongly recommend painless labor to those poor pain tolerated primigravida.

Adult↗
PubMed1994

[Surgical delivery: comparison of two 5-year periods].

Operative delivery prevalence is considered in two periods: 1980-1985 and 1986-1990. Reduced prevalence of repeated cesarean section is reported for the second period as opposed to the first one. A larger prevalence of cesarean sections for anomalous presentation (breech presentation included), fetal distress. EPH gestosis, abruptio placentae is reported in the second half of '80's. Vacuum Extractor applications are reduced in the second period compared to the first one for with concern secondary uterine hypokinesia; larger V.E. applications are reported in the second period for fetal distress in the second stage of labor. Relatively rare forceps applications in both periods.

Breech Presentation↗
PubMed1990

Neonatal and maternal outcome in low-pelvic and midpelvic operative deliveries.

A retrospective analysis of low-pelvic and midpelvic operative deliveries (according to the new definitions by the American College of Obstetricians and Gynecologists, 1989) matched with cesarean section deliveries of similar station was undertaken. In all vaginally delivered groups there was significantly decreased maternal morbidity, maternal hospital stay, and estimated blood loss. In the midpelvic deliveries, there was a significant increase in the frequency of neonatal resuscitation and an increase in base deficit for the umbilical artery. In both the midforceps and low-forceps groups, there was a significant increase of neonates with cord arterial pH less than 7.10, and an increase of base deficit, even when cases of fetal distress were eliminated. The midforceps group also had an increased rate of admission to the intensive care nursery and an increase in the risk of significant birth trauma. In considering a midforceps or midvacuum operative delivery, the potential associated risks to the neonate must be balanced against the benefits to the mother.

Birth Injuries↗
PubMedDate not supplied

Forceps or vacuum extraction: a comparison of maternal and neonatal morbidity.

To compare maternal and neonatal morbidity associated with forceps and vacuum delivery, data on 150 women delivered by forceps and 420 delivered by vacuum extraction between 1995 and 1999 at Queen Ala Hospital, Jordan were compared. Data included parity, gestational age, infant birthweight, Apgar score, presentation and station of fetal head, indications for forceps and vacuum deliveries, delivery success rate, and maternal and neonatal morbidity. Maternal birth canal and genital tract lacerations were significantly more common in forceps delivery, and there was significantly increased morbidity in infants delivered by vacuum extraction (caput, jaundice, cephalohaematoma). Serous neonatal morbidity was rare for both groups.

Adult↗
PubMed2004

Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors.

BACKGROUND: Subdural haematomas are thought to be uncommon in babies born at term. This view is mainly based on findings in symptomatic neonates and babies in whom subdural haemorrhages are detected fortuitously. We aimed to establish the frequency of subdural haemorrhages in asymptomatic term neonates; to study the natural history of such subdural haematomas; and to ascertain which obstetric factors, if any, are associated with presence of subdural haematoma. METHODS: We did a prospective study in babies who were born in the Jessop wing of the Central Sheffield University Hospitals between March, 2001, and November, 2002. We scanned neonates with a 0.2 T magnetic resonance machine. FINDINGS: 111 babies underwent MRI in this study. 49 were born by normal vertex delivery without instrumentation, 25 by caesarean section, four with forceps, 13 ventouse, 18 failed ventouse leading to forceps, one failed ventouse leading to caesarean section, and one failed forceps leading to caesarean section. Nine babies had subdural haemorrhages: three were normal vaginal deliveries (risk 6.1%), five were delivered by forceps after an attempted ventouse delivery (27.8%), and one had a traumatic ventouse delivery (7.7%). All babies with subdural haemorrhage were assessed clinically but no intervention was needed. All were rescanned at 4 weeks and haematomas had completely resolved. INTERPRETATION: Presence of unilateral and bilateral subdural haemorrhage is not necessarily indicative of excessive birth trauma.

Apgar Score↗