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PubMed1981

Vacuum extractor.

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Extraction, Obstetrical↗
PubMedDate not supplied

[Evaluation of the results of induced, stimulated, and other labour].

A total of 1229 deliveries in 1981 were analysed for the effect of the induction of labour on its duration, way of completion, and the newborn's vitality. It has been found that induction significantly reduces the duration of labour in primiparae, and in multiparae in particular. In induced labour vacuum extractor (P less than 0.010) and cesarean section (P less than 0.001) and in stimulated labour vacuum extractor (P less than 0.001) are more frequently used. The vitality of children is significantly lower in induced labour (Apgar 8-10: P less than 0.020; Apgar 4-7: P less than 0.010). Stimulation does not influence the distribution of the frequency of children according to the gestation age. There are no unsuccessful induced deliveries but only incorrect indications.

Apgar Score↗
PubMed2003

[Early maternal and neonatal morbidity after spontaneous and surgically-assisted vaginal delivery].

OBJECTIVE: To evaluate the differences in early maternal and neonatal morbidity after spontaneous delivery, forceps delivery and vacuum-extraction. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynecology, University Hospital, Palacký University, Olomouc. METHODS: The database of 8196 deliveries at our department in the time period from January 1995 till September 2000 revealed 183 of forceps deliveries and 217 of vacuum-extractions. The control group included 200 randomly selected parturients with spontaneous vaginal delivery. The early maternal morbidity was evaluated according to the following parameters: perineal tears of the IIIrd + IVth degree, duration of hospitalization, average blood loss, the need of analgetics, dehiscence of episiotomy requiring resuture, febrilies and administration of antibiotics. The early neonatal morbidity evaluation was based on the incidence of cephalhematomas, the incidence of hyperbilirubinaemia, duration of hospitalization, signs of fetal hypoxia (pH, Apgar score), gestational age, birthweight and the presence of intracranial and retinal bleeding. The statistical significance of the differences in the frequency of the above parameters was evaluated. RESULTS: Spontaneous deliveries were associated with lower maternal morbidity according to the most of studied parameters. Vacuum-extraction had a lower frequency of maternal postpartum complications compared to forceps deliveries. Statistically valid differences were however found only at perineal tears of the IIIrd + IVth degree and at administration of analgetic and antibiotics. The use of vacuum-extraction seems to be connected with a higher risk of cephalhematomas (p = 0.0051) and longer duration of hospitalization. CONCLUSIONS: From the point of view of early maternal morbidity the assisted vaginal delivery by vacuumextraction gives better results than by forceps. However vacuum-extraction increases the risk of cephalhematomas at newborn.

Extraction, Obstetrical↗
PubMed2001

Risk factors for third degree perineal ruptures during delivery.

OBJECTIVE: To determine risk factors for the occurrence of third degree perineal tears during vaginal delivery. DESIGN: A population-based observational study. POPULATION: All 284,783 vaginal deliveries in 1994 and 1995 recorded in the Dutch National Obstetric Database were included in the study. METHODS: Third degree perineal rupture was defined as any rupture involving the anal sphincter muscles. Logistic regression analysis was used to assess risk factors. MAIN OUTCOME MEASURES: An overall rate of third degree perineal ruptures of 1.94% was found. High fetal birthweight, long duration of the second stage of delivery and primiparity were associated with an elevated risk of anal sphincter damage. Mediolateral episiotomy appeared to protect strongly against damage to the anal sphincter complex during delivery (OR: 0.21, 95% CI: 0.20-0.23). All types of assisted vaginal delivery were associated with third degree perineal ruptures, with forceps delivery (OR: 3.33, 95%-CI: 2.97-3.74) carrying the largest risk of all assisted vaginal deliveries. Use of forceps combined with other types of assisted vaginal delivery appeared to increase the risk even further. CONCLUSIONS: Mediolateral episiotomy protects strongly against the occurrence of third degree perineal ruptures and may thus serve as a primary method of prevention of faecal incontinence. Forceps delivery is a stronger risk factor for third degree perineal tears than vacuum extraction. If the obstetric situation permits use of either instrument, the vacuum extractor should be the instrument of choice with respect to the prevention of faecal incontinence.

Anal Canal↗
PubMed1988

Vacuum extraction.

Vacuum extraction rivals forceps delivery in efficacy, is less traumatic to the mother and is as safe or safer than forceps delivery for the infant. Soft plastic cup extractors minimize the technical, maternal and fetal problems of vacuum extraction and have made this method of delivery ideal for the family physician who practices obstetrics.

Equipment Design↗