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PubMed1994

Vaginal operative deliveries in Italy.

OBJECTIVE: To analyze the trends in vaginal operative deliveries in Italy. DESIGN: Analysis of information on all deliveries after the 28th week of gestation, routinely collected by the Italian Central Institute of Statistics using a standard form. SETTING: National data on all Italian deliveries in the period 1981-85. SUBJECTS: All deliveries occurred in Italy in the period. RESULTS: Forceps and vacuum delivery were reported in 1981 respectively in 0.9 and 2.1/100 deliveries. Similar percentages were observed during the whole considered quinquennium for vacuum extraction, but the forceps delivery rate decreased to 0.6/100 in 1985. Nulliparous women more frequently had an operative vaginal delivery: the rates of forceps and vacuum deliveries were respectively 1.1 and 3.7/100 in nulliparae and 0.3 and 1.0 in women reporting one or more previous births. There was a direct relationship between vacuum delivery rate and birth weight: vacuum deliveries were reported for respectively 0.9 and 2.3/100 infants weighing less than 2500 g and > or = 2500 g. Likewise, vaginal operative deliveries were more frequent in term or post-term births, and vacuum deliveries among singleton births than multiple ones (2.3 vs 1.7/100 deliveries). CONCLUSIONS: Operative vaginal delivery rates in Italy in the mid 1980's were lower than in most developed countries. The reasons for forceps and vacuum extraction were similar to other developed countries with regard to obstetric determinants, but some differences emerged for socio-demographic factors.

Adult↗
PubMed1982

Deliveries in short-stay hospitals: United States, 1980.

During 1980 3.8 million women with deliveries were discharged from short-stay non-Federal hospitals in the United States. These women made up a sizable portion--9.9 percent--of all the discharges (excluding newborn infants) during that year. Women with deliveries remained hospitalized an average of 3.8 days and used 14.2 million days of inpatient hospital care. This was only 5.2 percent of the total days spent in hospitals by all patients discharged during the year. Most of the women who had a delivery were in their twenties, were white, and were married. The largest percent of deliveries occurred in the South Region, followed by the North Central, Northeast, and West Regions. The percent of women with deliveries was lowest in the smallest hospitals and highest in the largest hospitals. Most of the women with deliveries were discharged from nonprofit hospitals. About half of the women had a normal delivery and about half had some sort of complication. Women more likely to have a complicated delivery were older, were races other than white, had an unknown marital status, and had delivered in the South Region. These women also stayed in the hospital longer, on the average, than did women with normal delivery. The most frequently occurring complications were forceps or vacuum extraction without mention of indication and obstetrical trauma. Episiotomy was the most common procedure. Other frequently performed procedures were low forceps or vacuum extraction with or without episiotomy, cesarean section, repair of obstetric laceration, and bilateral destruction or occlusion of fallopian tubes.

Data Collection↗
PubMed1981

Preliminary report: a clinical appraisal of the McGoldrick rotational vacuum extractor.

The results of a preliminary clinical appraisal of a newly designed vacuum extractor - the McGoldrick rotational vacuum extracter is presented. This instrument is designed to combine the rotation advantages of the various rotating obstetric forceps with the multiple advantages of the conventional vacuum extractor in the management of persistent occipito posterior and occipito transverse positions. The design features include an elliptical shaped cup attached to a series of bars and universal joints which allow both rotational and traction forces to be applied to the foetal scalp.

Equipment Design↗
PubMed2000

[Surgical methods for delivery in modern obstetrics and their influence on maternal and infant health].

The article addresses issues of comparative characterization of deliveries involving surgery and impact thereof on the health of the mother and her child. Risk factors are identified that the mother and her child run in sectio cesarea, in application of obstetrical forceps, and in vacuum-extraction of the fetus. Cesarean section was found out to be the most acceptable mode of delivery in origination of organic and functional nervous system involvement in children but the most ill-chosen and unpropitious one in the mother, especially so in those groups at risk for bleeding, septic complications, and genital endometriosis. Among those surgical methods of delivery being the least traumatic to the mother are obstetrical forceps and vacuum-extraction of the fetus.

Adult↗
PubMed1978

[Modification of the vacuum extraction device (author's transl)].

The article describes a bell-shaped vacuum extractor with a rigid tube neck connected via a ball and socket joint. The advantages of this device over the "classical" device described by Malmström (2), are as follows: Easier insertion of the bell adjusted at an angle of 90 degrees, improved pushing-up of the bell for fastening to the head when this is still in elevated position, better placing of the bell at the desired location, better manipulation into the desired direction of pull, possibility of pushing up the anterior part in case of late cesarean section, and better sealing of the suction tube at the point of transition from the tube to the flexible hose. Another improvement concerns the adhesion, achieved by means of ring-shaped notches on the inside of the bell.

Cesarean Section↗
PubMed2003

Anorectal symptoms after various modes of vaginal delivery.

The aim of this study was to determine the prevalence of, and the changes in, anorectal symptoms following different modes of vaginal delivery in primiparous women. Six hundred and seventeen questionnaires were distributed to primiparous women 3-4 years after delivery. The questionnaires were designed to obtain information regarding the development of anorectal symptoms, including the type of symptoms experienced, their severity and their impact on lifestyle. A total of 479 questionnaires were returned, representing a response rate of 77.6%. Women included in the study were divided into three groups on the basis of the mode of delivery (normal vaginal, vacuum extraction and forceps). Any episode of fecal incontinence was considered to be abnormal. Following delivery, de novo incontinence developed in 22%. There was no significant difference between the three modes of vaginal delivery in terms of the development of fecal incontinence (normal vaginal delivery 22%, vacuum extraction 20%, forceps delivery 26%). Furthermore, analysis of obstetric variables could not identify one significant independent risk factor for anorectal incontinence. The results of this study suggest that instrumental vaginal deliveries are as safe as a normal vaginal delivery in terms of the development of anorectal symptoms.

Adult↗
PubMed2000

Assisted vaginal delivery using the vacuum extractor.

Vacuum extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup vacuum extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Vacuum extractors can cause neonatal injury. These devices should be employed when indicated, usually for a nonreassuring fetal heart tracing or failure to progress in the second stage of labor. Complications may be minimized if the physician recognizes contraindications to the use of vacuum extraction. Complete documentation is essential.

Equipment Design↗
PubMedDate not supplied

[Delivery with vacuum extraction--indications, technique and complications].

This study is a retrospective analysis of data on deliveries which ended up in vacuum extraction at the Clinic of Gynecology and Obstetrics in Novi Sad during two periods: 1983-85, and 1993-95. The aim of this study was to analyze indications, technique and complications of deliveries which ended up in vacuum extraction. Out of the total number of deliveries-17,110 in the period 1983-85, 4.86% ended up in vacuum extraction. The perinatal morbidity was 10.82%, the perinatal mortality 15.13/1000. In the period 1993-95, there were 18,599 deliveries, whereas 2.65% ended up in vacuum extraction. The perinatal morbidity was 8.93%, while perinatal mortality 11.12/1000. The risk of morbidity occurring in surgical procedures can be decreased if prompt vacuum extraction is performed.

Adult↗
PubMed1986

Follow up of babies delivered in a randomized controlled comparison of vacuum extraction and forceps delivery.

Babies delivered in a randomized controlled comparison of vacuum extraction vs. forceps delivery were reassessed at 9 months of age. There were no statistically significant differences between the two groups as regards head circumference, weight, or head circumference to weight ratio, nor in the results of hearing and vision tests. The reasons for hospital readmission, pediatric follow-up and parents' and health visitors' worries appeared to be unrelated to the mode of delivery in nearly all cases. The finding in the original trial that neonatal jaundice was more common following vacuum extraction was reinforced by an additional case of jaundice in the vacuum extractor group which had necessitated readmission to hospital.

Child Development↗
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↗
PubMed1976

[Vacuum extraction in interruption of pregnancy using a jagged cannula].

The author describes his experience with artificial abortus using vacuum aspiration performed with a jagged cannula of his own construction. In 2150 interruptions of pregnancy, the complications were as follows: residua in 0.2%, bleeding in 4.7%, and febrile condition in 2.5% of cases. The loss of blood was 30-200 ml.

Abortion, Induced↗