Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes
Year: 2019
Type: article
Abstract: OBJECTIVE: This study aimed 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.
Source: American Journal of Perinatology
Authors: Emily S. Miller, Yinglei Lai, Jennifer Bailit, Uma M. Reddy, Ronald J. Wapner, Michael W. Varner, John M. Thorp, Kenneth J. Leveno, Steve N. Caritis, Mona Prasad, Alan T. N. Tita, George R. Saade, Yoram Sorokin, Dwight J. Rouse, Sean C. Blackwell, Jorge E. Tolosa, for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network*
Institutions: Northwestern University, George Washington University, MetroHealth Medical Center, Case Western Reserve University, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Columbia University, University of Utah, University of Utah Health Care, University of North Carolina at Chapel Hill, The University of Texas Southwestern Medical Center, University of Pittsburgh, The Ohio State University, University of Alabama at Birmingham, The University of Texas Medical Branch at Galveston, Wayne State University, Brown University, Memorial Hermann, The University of Texas Health Science Center at Houston, Oregon Health & Science University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1216570417, G1648937940, Maternal Fetal Medicine Network: Data Coordinating Cent*, G1882602020, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network, G2254024324, Case Western Reserve University/Cleveland Clinic CTSA (UL1), NICHD Maternal Fetal Medicine Units Network, G2594613454, NICHD Maternal-Fetal Medicine Units (MFMU) Network, G284963502, G29782494, Maternal-Fetal Medicine Units Network, NICHD Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Cooperative Multicenter Maternal Fetal Medicine Units Networks, G3786447104, University of Utah Center for Clinical and Translational Science-UL1, G4027080872, G4238721334, Co-Operative Multicenter Trials in Obstetrics & Maternal Fetal Medicine, Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research Net, Multicenter Network of Maternal Fetal Medicine Units, G4657398957, G50908112, Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network (U10), G6657596466, G673807916, Brown/WIH Eunice Kennedy Shriver NICHD MFM Units Network Site, Maternal Fetal Medicine Network, NICHD Maternal Fetal Medicine Units Network, NICHD Materal Fetal Medicine Units Network, Clinical and Translational Science Collaborative of Cleveland, UofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical Centers, NICHD Maternal-Fetal Medicine Units (MFMU) Network: Data CoordinatingCenter, Brown University/Women & Infants Hospital of Rhode Island (WIH) Center Application for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network - Northwestern Study Center, Maternal-Fetal Medicine Units (MFMU) Network, Yale Clinical and Translational Science Award, Case Western Reserve University Center of the NICHD MFMU Network, Columbia University Maternal-Fetal Medicine Units Network Clinical Center, NICHD maternal fetal medicine units network, UNC MFMU: Advancing Perinatal Health via Definitive, Multi-Site Clinical Studies, Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units (MFMU) Network (UG1), G922324195
OpenAlex ID: W2923137352