Document Detail

Vacuum extraction versus forceps for assisted vaginal delivery.
MedLine Citation:
PMID:  10796182     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Proponents of vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother.
OBJECTIVES: The objective of this review was to assess the effects of vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: February 1999.
SELECTION CRITERIA: Acceptably controlled comparisons of vacuum extraction and forceps delivery.
DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information.
MAIN RESULTS: Ten trials were included. The trials were of reasonable quality. Use of the vacuum extractor for assisted vaginal delivery when compared to forceps delivery was associated with significantly less maternal trauma (odds ratio 0.41, 95% confidence interval 0.33 to 0.50) and with less general and regional anaesthesia. There were more deliveries with vacuum extraction (odds ratio 1.69, 95% confidence interval 1.31 to 2.19). Fewer caesarean sections were carried out in the vacuum extractor group. However the vacuum extractor was associated with an increase in neonatal cephalhaematomata and retinal haemorrhages. Serious neonatal injury was uncommon with either instrument.
REVIEWER'S CONCLUSIONS: Use of the vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity. The reduction in cephalhaematoma and retinal haemorrhages seen with forceps may be a compensatory benefit.
R B Johanson; B K Menon
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2000  
Date Detail:
Created Date:  2000-07-06     Completed Date:  2000-07-06     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  CD000224     Citation Subset:  IM    
Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital NHS Trust, Maternity Hospital, Newcastle Road, Stoke-on-Trent, Staffordshire, UK, ST4 6QG.
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MeSH Terms
Extraction, Obstetrical
Obstetrical Forceps*
Vacuum Extraction, Obstetrical*
Update In:
Cochrane Database Syst Rev. 2010;(11):CD000224   [PMID:  21069665 ]

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