Citation
Miller, Emily S.; Lai, Yinglei; Bailit, Jennifer L.; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M., Jr.; Leveno, Kenneth J.; Caritis, Steve N.; & Prasad, Mona, et al. (2020). Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes. American Journal of Perinatology, 37(5), 503-510. PMCID: PMC6754310Abstract
OBJECTIVE: To evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes.STUDY DESIGN: This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls.
RESULTS: Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application.
CONCLUSION: The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.
URL
http://dx.doi.org/10.1055/s-0039-1683439Reference Type
Journal ArticleYear Published
2020Journal Title
American Journal of PerinatologyAuthor(s)
Miller, Emily S.Lai, Yinglei
Bailit, Jennifer L.
Reddy, Uma M.
Wapner, Ronald J.
Varner, Michael W.
Thorp, John M., Jr.
Leveno, Kenneth J.
Caritis, Steve N.
Prasad, Mona
Tita, Alan T. N.
Saade, George R.
Sorokin, Yoram
Rouse, Dwight J.
Blackwell, Sean C.
Tolosa, Jorge E., for the
Eunice Kennedy Shriver
National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network