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Results for “Vacuum Extraction, Obstetrical”

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PubMed1983

Early office termination of pregnancy by soft cannula vacuum aspiration.

This report documents the results of an ongoing study of the first 454 consecutive outpatient abortions by menstrual extraction technique performed by the author over a span of 8 years. All patients had positive preevacuation pregnancy tests and the procedure was employed up to 9+ weeks from the first day of the last menstrual period. All procedures were carried out in an outpatient setting under local anesthesia. Pathologic evaluation revealed decidua and villi in all but 10 cases. Major complications were encountered in 2.6% of cases and in only two was laparotomy necessitated--one for a ruptured corpus luteum cyst and the other for an unruptured ectopic cornual pregnancy. The current application for the procedure is suggested by its technical simplicity and relative safety in population presenting for early termination of pregnancy.

Abortion, Induced↗
PubMedDate not supplied

Episiotomy in low-risk vaginal deliveries.

PURPOSE: The object of this study was to determine factors leading to episiotomy in low-risk vaginal deliveries, including a comparison of family physicians with obstetricians. The research was also to assess the incidence of episiotomy in a large community hospital and compare it with a national rate of 40%. METHODS: A retrospective cohort design was used with computerized records from one hospital. Demographic and clinical information was extracted from the database, including parity, age, physician type, anesthesia, induction, fetal complications, and other factors. Only low-risk vaginal deliveries (n = 3120) from the year 2003 were included. RESULTS: There was an overall episiotomy incidence of 48%; obstetricians performed episiotomy in 54% of their low-risk patients and family physicians in 33% of similar women (P < .001). Adjusted for multiple factors, the odds ratio for obstetricians performing episiotomy was 2.38 [1.98 to 2.87 (95% confidence interval (CI))]. Instrument-assisted delivery was the strongest predictor for episiotomy, with an adjusted odds ratio for forceps of 5.08 [3.75 to 6.88 CI], and vacuum 2.86 [1.78 to 4.58 CI]. CONCLUSION: Episiotomy in this hospital is being performed in almost half of all vaginal births. Obstetricians are more than twice as likely to perform episiotomy as family physicians in similar patients. Instrument-assisted delivery is a strong risk factor for episiotomy.

Adult↗
PubMed1980

Fetal EEG during vacuum extraction delivery with a special plastic ventouse.

A vacuum extractor cup made of plastic with built-in percutaneous silver electrodes for fetal EEG and ECG registration is described. In an experimental set up the mechanical properties of the cup were tested. The cup electrodes were tested on a 1-month-old infant and a satisfactory recording was obtained. During delivery a technically acceptable fetal EEG was recorded between but not during tractions. Comparison of the EEG before and after two pulls showed a generalized reduction of amplitude and a decrease of rhythmic slow wave activity. The results indicate that a plastic cup with EEG electrodes might be a useful tool in studying fetal cerebral functions during delivery by vacuum extraction.

Electroencephalography↗
PubMed2002

Obstetric attending physician characteristics and their impact on vacuum and forceps delivery rates: University of California at San Francisco experience from 1977 to 1999.

OBJECTIVE: The objective of our study was to determine the impact of obstetric attending physician characteristics (eg, region of previous residency training, sex, year of graduation from residency) on the rates of vacuum and forceps delivery at our institution. STUDY DESIGN: The analysis was based on 19,897 vaginal deliveries that were performed by 171 attending physicians and 160 resident physicians between 1977 and 1999 at the University of California at San Francisco Medical Center. Z -tests and multivariate logistic regression were performed on a perinatal database that contained standard obstetric variables. RESULTS: Male attending physicians had a higher percentage of forceps deliveries compared with female attending physicians (11.1% vs 6.6%; P <.001); female attending physicians had a higher percentage of vacuum deliveries compared with male attending physicians (9.8% vs 5.1%; P <.001). However, multivariate regression analysis revealed that only the year in which the procedure was performed affected both the forceps and vacuum delivery rates (P <.041). The region of previous residency training of the attending physician affected the vacuum delivery rate (P <.0001) but not the forceps delivery rate (P >.06) in multivariate logistic regression analysis. Factors such as the sex of the obstetric attending physician, the sex of the resident, and the year of graduation from residency for the obstetric attending physician did not have a significant impact on the forceps or vacuum delivery rates (all P >.05). CONCLUSION: Our study is the first to report that the apparent gender differences in forceps and vacuum delivery rates among obstetric attending physicians was due to the year in which the procedure was performed and not due to sex per se. We also found that the region of previous residency training for the obstetric attending physician significantly influenced the vacuum delivery rate.

Delivery, Obstetric↗