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At least 613 records · Page 34Linked to original sources
PubMed1992

Instrumental rotational delivery in primiparae.

We analysed 98 consecutive instrumental rotational deliveries of babies weighing > 2,500 grams in primiparae. Our aim was to compare the use of Kjelland's forceps with vacuum delivery with regard to efficacy and safety. The vaginal delivery rate was similar with Kjelland's forceps (96%) and vacuum (90%). The vacuum cup failed to effect rotation in 14% and 77% required forceps delivery after vacuum rotation. The vacuum took longer to effect delivery (P < 0.01). Women delivered with Kjelland's forceps had higher pain scores in the puerperium. There were no perinatal deaths. Low Apgar scores and cord arterial pH values of less than 7.20 were recorded more frequently after vacuum rotation (p < 0.05). Babies delivered with Kjelland's forceps sustained more physical trauma. The incidence of asphyxial encephalopathy was the same in both groups. We would recommend a more selective approach to the use of both rotational vacuum and Kjelland's forceps in primiparae.

Adult↗
PubMed1999

Vanishing forceps delivery.

This study evaluates the effect of decreasing cesarean rates and increasing regional anesthesia use on the frequency of forceps deliveries. Data of women who delivered at our community hospital from 1990 through 1997 are reviewed. In 1994, the members of our department adopted several strategies to decrease cesarean deliveries. The cesarean rate decreased whereas regional analgesia use increased. We studied the frequency and type of vaginal operative deliveries during this 8 year period. These data were evaluated by chi2 analysis. Data of women who delivered in the first 4 years (group 1) were compared with data of those who delivered in the second 4 years (group 2). A p < 0.05 was considered significant. The demographic and clinical characteristics of these women remained unchanged during the study period. The total cesarean rate decreased from 23.2% in group 1 to 17.9% in group 2 (p < 0.0001). The proportion of women who received regional anesthesia increased from 18.8 in group 1 to 25.7 in group 2 (p < 0.0001). Vaginal operative deliveries increased from 3.6 to 5.5 (p < 0.0001), whereas the proportion of forceps deliveries decreased from 2.2 to 1.5 (p = 0.001). Perinatal morbidity and mortality did not change. The decrease in cesarean rate and increase in regional anesthesia use were associated with an increase in operative deliveries; however, forceps deliveries continue to decrease in our community hospital.

Analgesia, Obstetrical↗
PubMed1981

Effect of instrumental delivery on the frequency and severity of retinal hemorrhages in the newborn.

The frequency and severity of retinal hemorrhages were studied in 200 newborns within the first 72 hours of life. One hundred of the neonates were delivered instrumentally by either forceps (49 cases) or vacuum extraction (51 cases). Another hundred neonates were delivered spontaneously and served as controls. Both the highest and the lowest frequency of retinal hemorrhages were found among the babies delivered by instrumentation. The actual values were 50 per cent in the vacuum groups and only 16 per cent in the forceps group (p less than 0.01). The spontaneously delivered babies, who served as controls, showed retinal hemorrhages in 41 per cent of the cases. The frequency of severe retinal hemorrhages was five times higher in the vacuum group compared to both the forceps group and the control group (p less than 0.01, p less than 0.001).

Extraction, Obstetrical↗
PubMed1991

Long-term effects of vacuum and forceps deliveries.

The long-term effects of vacuum and forceps deliveries are largely unknown. We determined the long-term outcome of instrumental deliveries in 52,282 infants born in Jerusalem between 1964 and 1972. For each individual, events at birth were related to results of an intelligence test and medical examination done at 17 years of age by the Israeli Defence Forces draft board. 1747 individuals were delivered by vacuum, 937 by forceps, 47,500 by spontaneous delivery, and 2098 by caesarean section. Crude data showed that mean intelligence scores at 17 were significantly higher (p less than 0.0001) in the vacuum and forceps deliveries groups than in the spontaneous-delivery group; however, after adjustment for confounding factors by stepwise multiple regression, these differences were no longer seen. Although the forceps-delivery group had functional impairment of feet, vision, and retina compared with the spontaneous-delivery group, and the vacuum-extraction group had impairment of the legs, differences were small. Our findings suggest that infants delivered by vacuum or forceps are not at risk of physical and cognitive impairment at 17 years of age.

Adolescent↗
PubMed1978

Obstetric aspects of adolescent pregnancy and delivery.

An analysis of 31 years of adolescent pregnancies and deliveries at Novi Sad Medical Facility is presented. Obstetric complications are discussed. The psychological impact of adolescent pregnancy is examined.

Abortion, Induced↗
PubMed2003

Effect of operative vaginal delivery on the outcome of permanent brachial plexus injury.

OBJECTIVE: To evaluate whether operative vaginal delivery worsens the extent and/or degree of permanent brachial plexus injury. STUDY DESIGN: We utilized a dataset (n = 104) of vaginal deliveries resulting in permanent brachial plexus injury that ultimately underwent litigation. We excluded patients on whom neonatal injury information was incomplete (n = 5). Patients who had an operative vaginal delivery (n = 33) were compared with those who did not (n = 66) in regard to neonatal outcome and the location and extent of neurologic injury. RESULTS: The 2 classes were similar in demographic and obstetric variables. There were no differences in rates of 5-minute Apgar scores < 7 (17.9%, or 5/28, vs. 5.2%, or 3/57, P = .1), complete neurologic injury to the brachial plexus (C5-T1) (39%, or 13/33, vs. 38%, or 25/66; P = 1.0) or avulsion of the nerve roots (44%, or 12/27, vs. 36%, or 18/50; P = .5) between those with operative or spontaneous vaginal delivery. CONCLUSION: Operative vaginal delivery did not increase the severity of impairment in a dataset of deliveries resulting in permanent brachial plexus injury.

Adult↗
PubMed1993

Does midline episiotomy increase the risk of third- and fourth-degree lacerations in operative vaginal deliveries?

OBJECTIVE: To explore the association between midline episiotomy and the risk of third- and fourth-degree lacerations during operative vaginal delivery with either vacuum extractor or forceps. METHODS: This retrospective cohort study analyzed all operative vaginal deliveries at a university hospital in 1989 and 1990. Univariate analysis of the relationships between perineal lacerations and obstetric variables was performed. Stratified analysis using the relevant variables was used to calculate relative risk (RR) estimates. RESULTS: Episiotomy, birth weight, and whether the index birth was the first vaginal birth were associated with third- and fourth-degree perineal lacerations. Stratified analysis demonstrated an RR of 2.4 with a 95% confidence interval of 1.7-3.5 for rectal injury with episiotomy, adjusting for parity and birth weight. CONCLUSION: Midline episiotomy is associated with an increased risk of third- and fourth-degree perineal lacerations in operative vaginal deliveries.

Birth Weight↗