Failed individual and sequential instrumental vaginal delivery: contributing risk factors and maternal-neonatal complications
Background. To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal and neonatal morbidity associated with failed individual and sequential instruments used. Design. A retrospective case‐control study. Methods. From January 1995 to June 2001, there were 39 5...
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| Veröffentlicht in: | Acta obstetricia et gynecologica Scandinavica 2003-07, Vol.82 (7), p.642-648 |
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| creator | Al-Kadri, Hanan Sabr, Yasser Al-Saif, Saif Abulaimoun, Bdair Ba'Aqeel, Hassan Saleh, Ahmed |
| description | Background. To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal and neonatal morbidity associated with failed individual and sequential instruments used.
Design. A retrospective case‐control study.
Methods. From January 1995 to June 2001, there were 39 508 live births at >37 weeks' gestation of which 2628 (6.7%) instrumental vaginal deliveries were performed, 1723 (4.4%) were vacuum extractions and 905 (2.3%) were forceps. A total of 155/2628 (5.9%) patients who had failed instrumental delivery were matched with 204 patients who had successful instrumental delivery. The patients were divided into five groups. Group I (n = 129) had failed vacuum extraction, group II (n = 13) failed forceps, group III (n = 13) failed both (i.e. failed attempt at both instruments sequentially), group IV (n = 138) had successful vacuum extraction and group V (n = 66) successful forceps.
Results. The failure rate for vacuum extractions 129/1723 (7.5%) was significantly higher than that for forceps 13/905 (1.4%) [odds ratio (OR) = 5.6, 95% CI 3–10.3]. There were no significant differences in all maternal complications (25.5% vs. 26.6%) between vacuum (groups I and IV) and forceps (groups II and V) assisted deliveries. There were more maternal complications in group III (46.2%) than in groups I (35.7%), II (23.1%) and V (27.3%) that did not reach statistical significance but were significantly higher than in group IV (15.9%, OR = 4.5, 95% CI 1.2–16.9). There was a significantly higher rate of all fetal complications in group III [11/13 (84.6%)] than in groups I [69/129 (53.5%)], II [7/13 (53.8%)], IV [35/138 (25.4%)] and V [22/66 (33.3%)] (OR = 4.8, 95% CI 0.9–19.9).
Conclusions. Applying the instrument at ≤0 fetal station, nulliparous women, history of previous cesarean section and fetal head other than occipitoanterior position were risk factors for failed instrumental delivery. Sequential use of instrumental delivery carries a significantly higher neonatal morbidity than when a single instrument is used. |
| doi_str_mv | 10.1034/j.1600-0412.2003.00162.x |
| format | Article |
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Design. A retrospective case‐control study.
Methods. From January 1995 to June 2001, there were 39 508 live births at >37 weeks' gestation of which 2628 (6.7%) instrumental vaginal deliveries were performed, 1723 (4.4%) were vacuum extractions and 905 (2.3%) were forceps. A total of 155/2628 (5.9%) patients who had failed instrumental delivery were matched with 204 patients who had successful instrumental delivery. The patients were divided into five groups. Group I (n = 129) had failed vacuum extraction, group II (n = 13) failed forceps, group III (n = 13) failed both (i.e. failed attempt at both instruments sequentially), group IV (n = 138) had successful vacuum extraction and group V (n = 66) successful forceps.
Results. The failure rate for vacuum extractions 129/1723 (7.5%) was significantly higher than that for forceps 13/905 (1.4%) [odds ratio (OR) = 5.6, 95% CI 3–10.3]. There were no significant differences in all maternal complications (25.5% vs. 26.6%) between vacuum (groups I and IV) and forceps (groups II and V) assisted deliveries. There were more maternal complications in group III (46.2%) than in groups I (35.7%), II (23.1%) and V (27.3%) that did not reach statistical significance but were significantly higher than in group IV (15.9%, OR = 4.5, 95% CI 1.2–16.9). There was a significantly higher rate of all fetal complications in group III [11/13 (84.6%)] than in groups I [69/129 (53.5%)], II [7/13 (53.8%)], IV [35/138 (25.4%)] and V [22/66 (33.3%)] (OR = 4.8, 95% CI 0.9–19.9).
Conclusions. Applying the instrument at ≤0 fetal station, nulliparous women, history of previous cesarean section and fetal head other than occipitoanterior position were risk factors for failed instrumental delivery. Sequential use of instrumental delivery carries a significantly higher neonatal morbidity than when a single instrument is used.</description><identifier>ISSN: 0001-6349</identifier><identifier>EISSN: 1600-0412</identifier><identifier>DOI: 10.1034/j.1600-0412.2003.00162.x</identifier><identifier>PMID: 12790846</identifier><identifier>CODEN: AOGSAE</identifier><language>eng</language><publisher>Oxford, UK: Munksgaard International Publishers</publisher><subject>Adult ; Biological and medical sciences ; Case-Control Studies ; cesarean section ; Delivery, Obstetric - statistics & numerical data ; Delivery. Postpartum. Lactation ; Extraction, Obstetrical - statistics & numerical data ; Female ; forceps ; Gynecology. Andrology. Obstetrics ; Humans ; Labor Stage, Second ; maternal and neonatal morbidity ; Medical Records ; Medical sciences ; Obstetric Labor Complications - epidemiology ; Obstetric Labor Complications - etiology ; Obstetrical Forceps - adverse effects ; Obstetrical Forceps - statistics & numerical data ; Obstetrical techniques ; Odds Ratio ; Parity ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Risk Factors ; Saudi Arabia - epidemiology ; Treatment Failure ; Tropical medicine ; vacuum extraction ; Vacuum Extraction, Obstetrical - statistics & numerical data</subject><ispartof>Acta obstetricia et gynecologica Scandinavica, 2003-07, Vol.82 (7), p.642-648</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4822-43f33cfcafc0af567f8891f0ee4452b42af087a0384c88968231e6b808af4d663</citedby><cites>FETCH-LOGICAL-c4822-43f33cfcafc0af567f8891f0ee4452b42af087a0384c88968231e6b808af4d663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1034%2Fj.1600-0412.2003.00162.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1034%2Fj.1600-0412.2003.00162.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14887495$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12790846$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Al-Kadri, Hanan</creatorcontrib><creatorcontrib>Sabr, Yasser</creatorcontrib><creatorcontrib>Al-Saif, Saif</creatorcontrib><creatorcontrib>Abulaimoun, Bdair</creatorcontrib><creatorcontrib>Ba'Aqeel, Hassan</creatorcontrib><creatorcontrib>Saleh, Ahmed</creatorcontrib><title>Failed individual and sequential instrumental vaginal delivery: contributing risk factors and maternal-neonatal complications</title><title>Acta obstetricia et gynecologica Scandinavica</title><addtitle>Acta Obstet Gynecol Scand</addtitle><description>Background. To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal and neonatal morbidity associated with failed individual and sequential instruments used.
Design. A retrospective case‐control study.
Methods. From January 1995 to June 2001, there were 39 508 live births at >37 weeks' gestation of which 2628 (6.7%) instrumental vaginal deliveries were performed, 1723 (4.4%) were vacuum extractions and 905 (2.3%) were forceps. A total of 155/2628 (5.9%) patients who had failed instrumental delivery were matched with 204 patients who had successful instrumental delivery. The patients were divided into five groups. Group I (n = 129) had failed vacuum extraction, group II (n = 13) failed forceps, group III (n = 13) failed both (i.e. failed attempt at both instruments sequentially), group IV (n = 138) had successful vacuum extraction and group V (n = 66) successful forceps.
Results. The failure rate for vacuum extractions 129/1723 (7.5%) was significantly higher than that for forceps 13/905 (1.4%) [odds ratio (OR) = 5.6, 95% CI 3–10.3]. There were no significant differences in all maternal complications (25.5% vs. 26.6%) between vacuum (groups I and IV) and forceps (groups II and V) assisted deliveries. There were more maternal complications in group III (46.2%) than in groups I (35.7%), II (23.1%) and V (27.3%) that did not reach statistical significance but were significantly higher than in group IV (15.9%, OR = 4.5, 95% CI 1.2–16.9). There was a significantly higher rate of all fetal complications in group III [11/13 (84.6%)] than in groups I [69/129 (53.5%)], II [7/13 (53.8%)], IV [35/138 (25.4%)] and V [22/66 (33.3%)] (OR = 4.8, 95% CI 0.9–19.9).
Conclusions. Applying the instrument at ≤0 fetal station, nulliparous women, history of previous cesarean section and fetal head other than occipitoanterior position were risk factors for failed instrumental delivery. Sequential use of instrumental delivery carries a significantly higher neonatal morbidity than when a single instrument is used.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>cesarean section</subject><subject>Delivery, Obstetric - statistics & numerical data</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Extraction, Obstetrical - statistics & numerical data</subject><subject>Female</subject><subject>forceps</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Labor Stage, Second</subject><subject>maternal and neonatal morbidity</subject><subject>Medical Records</subject><subject>Medical sciences</subject><subject>Obstetric Labor Complications - epidemiology</subject><subject>Obstetric Labor Complications - etiology</subject><subject>Obstetrical Forceps - adverse effects</subject><subject>Obstetrical Forceps - statistics & numerical data</subject><subject>Obstetrical techniques</subject><subject>Odds Ratio</subject><subject>Parity</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Saudi Arabia - epidemiology</subject><subject>Treatment Failure</subject><subject>Tropical medicine</subject><subject>vacuum extraction</subject><subject>Vacuum Extraction, Obstetrical - statistics & numerical data</subject><issn>0001-6349</issn><issn>1600-0412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFv0zAUxi0EYqXwL6Bc4Jbg2K7jIi5joh1QsQsIaRfr1bEnd4nT2UlpD_vf97JW25XT82d_3_Pzz4RkJS1KysWnTVFKSnMqSlYwSnlBaSlZsX9BJk8HL8mE4nYuuZifkTcpbVCxSqjX5AzrnCohJ-R-Ab6xdeZD7Xe-HqDJINRZsneDDb1H6UPq49CiQrGDGx-w1rbxOxsPnzPThT769dD7cJNFn24zB6bvYnrs00JvIwbyYLsAYwfTtdvGG-h9F9Jb8spBk-y7U52SP4tvvy8u89XV8vvF-So3QjGWC-44N86AMxTcTFZOqXnpqLVCzNhaMHBUVUC5EgZPpGK8tHKtqAInain5lHw89t3GDh-Wet36ZGzTAM41JF1xLhhDtFOijkYTu5SidXobfQvxoEuqR_R6o0fCeiSsR_T6Eb3eY_T96Y5h3dr6OXhijYYPJwMkA42LEIxPzz6hVCXmM_R9Ofr-4c8c_nsAfX61xAXG82Pcp97un-IQb7WseDXTf38t9fX16gf_evlTL_gDU9Gw4w</recordid><startdate>200307</startdate><enddate>200307</enddate><creator>Al-Kadri, Hanan</creator><creator>Sabr, Yasser</creator><creator>Al-Saif, Saif</creator><creator>Abulaimoun, Bdair</creator><creator>Ba'Aqeel, Hassan</creator><creator>Saleh, Ahmed</creator><general>Munksgaard International Publishers</general><general>Taylor & Francis</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200307</creationdate><title>Failed individual and sequential instrumental vaginal delivery: contributing risk factors and maternal-neonatal complications</title><author>Al-Kadri, Hanan ; Sabr, Yasser ; Al-Saif, Saif ; Abulaimoun, Bdair ; Ba'Aqeel, Hassan ; Saleh, Ahmed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4822-43f33cfcafc0af567f8891f0ee4452b42af087a0384c88968231e6b808af4d663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>cesarean section</topic><topic>Delivery, Obstetric - statistics & numerical data</topic><topic>Delivery. Postpartum. Lactation</topic><topic>Extraction, Obstetrical - statistics & numerical data</topic><topic>Female</topic><topic>forceps</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Labor Stage, Second</topic><topic>maternal and neonatal morbidity</topic><topic>Medical Records</topic><topic>Medical sciences</topic><topic>Obstetric Labor Complications - epidemiology</topic><topic>Obstetric Labor Complications - etiology</topic><topic>Obstetrical Forceps - adverse effects</topic><topic>Obstetrical Forceps - statistics & numerical data</topic><topic>Obstetrical techniques</topic><topic>Odds Ratio</topic><topic>Parity</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Saudi Arabia - epidemiology</topic><topic>Treatment Failure</topic><topic>Tropical medicine</topic><topic>vacuum extraction</topic><topic>Vacuum Extraction, Obstetrical - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al-Kadri, Hanan</creatorcontrib><creatorcontrib>Sabr, Yasser</creatorcontrib><creatorcontrib>Al-Saif, Saif</creatorcontrib><creatorcontrib>Abulaimoun, Bdair</creatorcontrib><creatorcontrib>Ba'Aqeel, Hassan</creatorcontrib><creatorcontrib>Saleh, Ahmed</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Al-Kadri, Hanan</au><au>Sabr, Yasser</au><au>Al-Saif, Saif</au><au>Abulaimoun, Bdair</au><au>Ba'Aqeel, Hassan</au><au>Saleh, Ahmed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Failed individual and sequential instrumental vaginal delivery: contributing risk factors and maternal-neonatal complications</atitle><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle><addtitle>Acta Obstet Gynecol Scand</addtitle><date>2003-07</date><risdate>2003</risdate><volume>82</volume><issue>7</issue><spage>642</spage><epage>648</epage><pages>642-648</pages><issn>0001-6349</issn><eissn>1600-0412</eissn><coden>AOGSAE</coden><abstract>Background. To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal and neonatal morbidity associated with failed individual and sequential instruments used.
Design. A retrospective case‐control study.
Methods. From January 1995 to June 2001, there were 39 508 live births at >37 weeks' gestation of which 2628 (6.7%) instrumental vaginal deliveries were performed, 1723 (4.4%) were vacuum extractions and 905 (2.3%) were forceps. A total of 155/2628 (5.9%) patients who had failed instrumental delivery were matched with 204 patients who had successful instrumental delivery. The patients were divided into five groups. Group I (n = 129) had failed vacuum extraction, group II (n = 13) failed forceps, group III (n = 13) failed both (i.e. failed attempt at both instruments sequentially), group IV (n = 138) had successful vacuum extraction and group V (n = 66) successful forceps.
Results. The failure rate for vacuum extractions 129/1723 (7.5%) was significantly higher than that for forceps 13/905 (1.4%) [odds ratio (OR) = 5.6, 95% CI 3–10.3]. There were no significant differences in all maternal complications (25.5% vs. 26.6%) between vacuum (groups I and IV) and forceps (groups II and V) assisted deliveries. There were more maternal complications in group III (46.2%) than in groups I (35.7%), II (23.1%) and V (27.3%) that did not reach statistical significance but were significantly higher than in group IV (15.9%, OR = 4.5, 95% CI 1.2–16.9). There was a significantly higher rate of all fetal complications in group III [11/13 (84.6%)] than in groups I [69/129 (53.5%)], II [7/13 (53.8%)], IV [35/138 (25.4%)] and V [22/66 (33.3%)] (OR = 4.8, 95% CI 0.9–19.9).
Conclusions. Applying the instrument at ≤0 fetal station, nulliparous women, history of previous cesarean section and fetal head other than occipitoanterior position were risk factors for failed instrumental delivery. Sequential use of instrumental delivery carries a significantly higher neonatal morbidity than when a single instrument is used.</abstract><cop>Oxford, UK</cop><pub>Munksgaard International Publishers</pub><pmid>12790846</pmid><doi>10.1034/j.1600-0412.2003.00162.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences Case-Control Studies cesarean section Delivery, Obstetric - statistics & numerical data Delivery. Postpartum. Lactation Extraction, Obstetrical - statistics & numerical data Female forceps Gynecology. Andrology. Obstetrics Humans Labor Stage, Second maternal and neonatal morbidity Medical Records Medical sciences Obstetric Labor Complications - epidemiology Obstetric Labor Complications - etiology Obstetrical Forceps - adverse effects Obstetrical Forceps - statistics & numerical data Obstetrical techniques Odds Ratio Parity Pregnancy Pregnancy Outcome Retrospective Studies Risk Factors Saudi Arabia - epidemiology Treatment Failure Tropical medicine vacuum extraction Vacuum Extraction, Obstetrical - statistics & numerical data |
| title | Failed individual and sequential instrumental vaginal delivery: contributing risk factors and maternal-neonatal complications |
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