PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Vacuum Extraction, Obstetrical”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed1994

Abdominal rescue using the vacuum extractor after entrapment of the aftercoming head.

BACKGROUND: Fetal replacement into the uterus for ceasarean delivery after failed vaginal delivery has been reported for both vertex and breech presentations. Although an option, this mode of delivery frequently is the last maneuver to deliver a viable infant after other methods to allow vaginal delivery have failed. We report the adjunctive use of a vacuum extractor to facilitate abdominal rescue after entrapment of the aftercoming head during an attempted vaginal breech delivery. CASE: A multiparous woman presented at term with two fetal feet bulging through the membranes at the introitus. During vaginal breech delivery, the aftercoming head became entrapped. Unsuccessful maneuvers to facilitate descent included Dührssen incisions, the Mauriceau maneuver, placement of Piper forceps, and halothane administration. At emergency ceasarean delivery, the infant was pushed upward from below, and rapid, successful delivery of a 2530-g neonate was accomplished with assistance by a vacuum extractor. Apgar scores were 3, 6, and 7 at 1, 5, and 10 minutes, respectively. Umbilical artery blood gas revealed a pH of 7.18 and base excess of -6. A head sonogram and electroencephalogram were normal. Both mother and infant were discharged without complications. CONCLUSION: After entrapment of the aftercoming head during attempted vaginal breech delivery, use of the vacuum extractor may expedite the abdominal rescue and ceasarean.

Adult↗
PubMed1997

Neonatal cephalohematoma from vacuum extraction.

OBJECTIVE: To identify factors involved in the development of fetal cephalohematoma from vacuum extraction. STUDY DESIGN: Patients at > or = 34 weeks' gestation were randomly assigned to delivery by vacuum (n = 322) using the continuous (n = 164) or intermittent (n = 158) technique. Neonatal outcome with cephalohematoma was analyzed subsequently and related to prospectively recorded data. RESULTS: Approximately equal numbers of cephalohematoma were recorded in the two groups (continuous 20, intermittent 17; P = .686). Station at point of application (P = .008), increasing asynclitism (P < .001) and increasing application to delivery time (P = .002) correlated significantly with cephalohematoma. Only the last two factors achieved significance after stepwise multiple logistic regression analysis. Factors that did not achieve statistical significance were gestational age (P = .755), birth weight (P = .982), instrumental rotation (P = .896) and previous vaginal delivery (P = .051). CONCLUSION: In this prospective, randomized, controlled trial of vacuum-assisted delivery, the only predelivery factor found to predispose to neonatal cephalohematoma formation was increasing asynclitism. Although cephalohematoma formation was more likely to develop as the duration of vacuum application increased during delivery, only 28% of neonates exhibited this finding when the time from vacuum application to delivery exceeded five minutes.

Female↗
PubMedDate not supplied

Vacuum extraction delivery complicated with acute subdural hematoma and cerebral infarction: report of one case.

We present a term, 2950 gm female neonate who was delivered by vacuum extraction and subsequently developed convulsions 23 hours after birth. Acute subduralhematoma was rapidly diagnosed by computed tomographic brain scan and successfully removed. The patient had a smooth postoperative recovery but cerebral infarction was found during follow up imaging studies. Magnetic resonance angiography revealed poor visualization of bilateral posterior cerebral arteries. After a follow-up period of 4 months, the infant had normal neurological development except for mild microcephalus. We report the occurrence of cerebral infarction in an infant following evacuation of a subdural hematoma. Onset of the late complication suggests the importance of serial neuroradiological and clinical evaluations.

Cerebral Infarction↗
PubMed1998

Comparison of vacuum extraction delivery between the conventional metal cup and the new soft rubber cup.

To compare the effectiveness and complications of vacuum extraction delivery between the conventional metal cup and the silicone rubber cup. A prospective randomized clinical trial of 90 pregnant women requiring assisted vaginal delivery who met the predetermined criteria for vacuum extraction were allocated to delivery by the Malstrom metal cup (46 cases) or the silicone rubber cup (44 cases). The two groups were similar in respect of age, parity gestational age and indications for assisted vaginal delivery. The mean and median numbers of tractions and time from cup application to delivery were not significantly different between the groups. The overall success rate was higher in the metal cup (89.1%) than in the rubber cup (79.5%) but not significantly different. The silicone cup was more likely to fail in cases of occiput posterior position, excessive caput, and severe degree of molding. There were no significant differences between groups in terms of Apgar scores, birth canal injury, and maternal blood loss. Scalp injuries occurred more frequently with the metal than with the rubber cup (P = 0.006). Vacuum extraction delivery with the silicone rubber cup is associated with reduced scalp injuries but has a greater tendency to fail when the fetus presents in occiput posterior position, has excessive caput or severe degree of molding.

Adolescent↗
PubMed1988

Laboratory comparison of modern vacuum extractors.

The Malmström, Soft Cup, and Mity-Vac vacuum extractors were compared in the laboratory using a tensile strength tester and a fetal cephalic model. In the test system, a linear relationship emerged between applied vacuum and maximal tractive force for all of the vacuum extractors. At their recommended working pressures, they allowed a maximum of 18-20 kg of tractive force to assist in a delivery. Calculation of the distribution of this force per unit area would appear to favor the Soft Cup. At high vacuums, all showed large amounts of tractive force and high forces per unit area. The data clearly demonstrate that high vacuum would have potentially adverse effects on the fetus and thus should be avoided.

Equipment Design↗
PubMed2005

The disappearing art of instrumental delivery: time to reverse the trend.

PURPOSE: This paper focuses attention on declining rates of instrumental (vacuum or forceps) delivery. The decline often means that women must travel further to deliver in hospitals with capacity for cesarean delivery. BACKGROUND: The paper illustrates recent trends in the use of vacuum extraction and forceps in low- and high-income countries. It describes some of the obstacles to the use of instrumental delivery and why the techniques, especially vacuum extraction, should be reintroduced. Over the past two decades, many countries have observed a decline in instrumental delivery rates while cesarean rates have increased. Objections to instrumental delivery are largely due to the potential harm it causes newborns. Some medical schools no longer train their professionals to perform instrumental delivery. Elsewhere, only specialists are permitted to perform the procedures. METHODS AND RESULTS: As this is a policy paper rather than a research report, the methods and results sections are not applicable. CONCLUSIONS: Vacuum extraction can be taught to midlevel practitioners (midwives, nurse practitioners and general physicians), thereby increasing access to emergency obstetric care especially at the periphery. This allows women to give birth closer to home in midlevel facilities when hospitals are not easily accessible or are overcrowded. Where instrumental and cesarean delivery are both available, instrumental delivery could potentially reduce the risks associated with cesarean delivery and reduce the costs of obstetric care.

Cesarean Section↗
PubMed2001

Failed vacuum extraction. Maternal risk factors and pregnancy outcome.

OBJECTIVE: To evaluate obstetric risk factors associated with a failed trial of vacuum extraction and to assess its pregnancy outcome. STUDY DESIGN: All attempted vacuum extractions between the years 1990 and 1998 were identified, and a comparison of successful and failed trials of vacuum extraction in singleton, vertex deliveries was performed. RESULTS: Of 2,111 trials of vacuum extraction, 113 (5.4%) cases were complicated by failed extraction and underwent cesarean section. Those neonates were significantly more likely to be large for gestational age, specifically to weigh > 4,000 g as compared to the controls. Patients lacking prenatal care had significantly higher rates of failed vacuum extraction trials. While cervical and uterine tears were rather rare, parturients who had failed trials of vacuum extraction had significantly higher rates of cervical and uterine tears as compared to those with successful vacuum extractions. This association remained significant after controlling for a previous cesarean section using the Mantel-Hanszel technique. Women from the failed vacuum extraction group had significantly higher rates of postpartum anemia. Pregnancies complicated by failed vacuum extraction had significantly higher rates of intrapartum and postpartum fetal death. Those neonates had significantly higher rates of Apgar scores < 7 at one and five minutes. CONCLUSION: Failed trial of vacuum extraction is associated with adverse maternal and fetal outcomes. Risk factors associated with such failures are fetal weight and lack of prenatal care. Thus, careful estimation of fetal weight should be performed before the procedure, and estimated fetal weight > 4,000 g might be considered a relative contraindication to vacuum extraction, especially among patients who did not have prenatal care.

Adolescent↗