TY - JOUR
T1 - Pregnancy outcome after cesarean section following a failed vacuum attempt
AU - Attali, Emmanuel
AU - Reicher, Lee
AU - Many, Ariel
AU - Maslovitz, Sharon
AU - Gamzu, Ronni
AU - Yogev, Yariv
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Objective: To compare the pregnancy outcome of women who underwent cesarean section in the second stage of labor, with or without a vacuum extraction attempt Methods: A retrospective cohort study of women who underwent a cesarean section during the second stage of labor in a single tertiary university-affiliated medical center (2012–2019). Pregnancy outcome was compared for women who underwent cesarean section following a failed vacuum extraction to women who had cesarean section during the second stage of labor with no vacuum extraction attempt. Neonatal outcomes included umbilical artery pH less than 7.1, Apgar at 5 min < 7, hypoxemic ischemic encephalopathy and NICU admission. Maternal outcomes included duration of hospitalization, need for blood transfusion and need for re-surgery in 45 days. Results: Overall, 88,375 women delivered during the study period. Of them, 120 women had a cesarean section following a failed vacuum (study group). Another 551 women underwent a cesarean section in the second stage of labor without a VE attempt (control group). The groups were similar with regard to obstetrical and demographic characteristics. The rates of umbilical artery pH < 7.1 (17.50% vs 6.53%, p <.001), NICU admission (13.33% vs 2.90%, p <.001), hypoxemic ischemic encephalopathy (5.83% vs 0.18%, p <.001) and epicranial sub-aponeurotic hemorrhage (16.67% vs 2.18%, p <.001) were significantly higher in the study group. No significant differences were found in maternal outcomes. In a sub-analysis including only labor with reassuring fetal heart tracing, failed vacuum attempt was associated with higher rate of NICU admission and epicranial hemorrhage (16.67% vs 3.13%, p =.009, 27.78% vs. 3.41, p =.001, respectively). Conclusion: Failed vacuum attempt is associated with a significant increased neonatal morbidity, but not increased maternal morbidity.
AB - Objective: To compare the pregnancy outcome of women who underwent cesarean section in the second stage of labor, with or without a vacuum extraction attempt Methods: A retrospective cohort study of women who underwent a cesarean section during the second stage of labor in a single tertiary university-affiliated medical center (2012–2019). Pregnancy outcome was compared for women who underwent cesarean section following a failed vacuum extraction to women who had cesarean section during the second stage of labor with no vacuum extraction attempt. Neonatal outcomes included umbilical artery pH less than 7.1, Apgar at 5 min < 7, hypoxemic ischemic encephalopathy and NICU admission. Maternal outcomes included duration of hospitalization, need for blood transfusion and need for re-surgery in 45 days. Results: Overall, 88,375 women delivered during the study period. Of them, 120 women had a cesarean section following a failed vacuum (study group). Another 551 women underwent a cesarean section in the second stage of labor without a VE attempt (control group). The groups were similar with regard to obstetrical and demographic characteristics. The rates of umbilical artery pH < 7.1 (17.50% vs 6.53%, p <.001), NICU admission (13.33% vs 2.90%, p <.001), hypoxemic ischemic encephalopathy (5.83% vs 0.18%, p <.001) and epicranial sub-aponeurotic hemorrhage (16.67% vs 2.18%, p <.001) were significantly higher in the study group. No significant differences were found in maternal outcomes. In a sub-analysis including only labor with reassuring fetal heart tracing, failed vacuum attempt was associated with higher rate of NICU admission and epicranial hemorrhage (16.67% vs 3.13%, p =.009, 27.78% vs. 3.41, p =.001, respectively). Conclusion: Failed vacuum attempt is associated with a significant increased neonatal morbidity, but not increased maternal morbidity.
KW - Failed vacuum
KW - cesarean section
KW - operative vaginal birth
KW - second stage of labor
UR - http://www.scopus.com/inward/record.url?scp=85096190930&partnerID=8YFLogxK
U2 - 10.1080/14767058.2020.1849122
DO - 10.1080/14767058.2020.1849122
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C2 - 33203289
AN - SCOPUS:85096190930
SN - 1476-7058
VL - 35
SP - 4375
EP - 4380
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 22
ER -