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Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes
Journal article   Open access   Peer reviewed

Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

Emily S Miller, Yinglei Lai, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp Jr, Kenneth J Leveno, Steve N Caritis, Mona Prasad, …
American journal of perinatology, Vol.37(5), pp.503-510
04/2020
DOI: 10.1055/s-0039-1683439
PMCID: PMC6754310
PMID: 30895577
url
https://www.ncbi.nlm.nih.gov/pmc/articles/6754310View
Open Access

Abstract

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. 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. 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. The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.
Pregnancy Adult Extraction, Obstetrical - adverse effects Extraction, Obstetrical - instrumentation Female Humans Infant, Newborn Infant, Newborn, Diseases - etiology Lacerations - etiology Obstetric Labor Complications - surgery Obstetrical Forceps - adverse effects Operative Time Treatment Failure Vacuum Extraction, Obstetrical - adverse effects

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