How safe is preterm operative vaginal delivery and which is the instrument of choice?

J Perinat Med. 2013 Jan;41(1):57-60. doi: 10.1515/jpm-2012-0092.

Abstract

Objective: The objective of this study was to determine neonatal outcomes in preterm operative vaginal delivery given the current paucity of data available to guide clinicians.

Study design: A retrospective review of 64 cases was conducted, and neonatal outcomes were compared to spontaneous vaginal deliveries in similar gestations. The primary outcomes studied were death and occurrence of intraventricular haemorrhage. Secondary outcomes included admission to NICU, Apgar < 3 at 5 min, ventilation requirement, jaundice requiring treatment, culture-proven sepsis and necrotising enterocolitis. The study was conducted in a stand-alone maternity unit of approximately 9000 deliveries per year.

Results and conclusions: We concluded that although vacuum delivery is avoided in preterm infants, outcomes were similar to forceps deliveries of similar gestations.

MeSH terms

  • Birth Injuries / epidemiology*
  • Birth Injuries / etiology
  • Cerebral Hemorrhage / epidemiology*
  • Cerebral Hemorrhage / etiology
  • Delivery, Obstetric / adverse effects*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Obstetrical Forceps / adverse effects
  • Patient Safety
  • Perinatal Mortality
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Premature Birth*
  • Retrospective Studies
  • Vacuum Extraction, Obstetrical / adverse effects