Document Detail

A randomized comparison of assisted vaginal delivery by obstetric forceps and polyethylene vacuum cup.
MedLine Citation:
PMID:  1923198     Owner:  NLM     Status:  MEDLINE    
The assisted vaginal delivery methods of rigid obstetric forceps and polyethylene vacuum cup extraction were compared in a prospective, randomized study. The 99 women studied had all completed 35 full weeks' gestation, required attempted assisted vaginal delivery, and were randomly assigned to either attempted forceps or vacuum-assisted delivery. All presentations were cephalic, with stations ranging from +1 to +4. Neonates were evaluated at 24 hours by neonatal staff. The infants underwent intracranial ultrasound screening during the first 24 hours of life and ophthalmologic examination within 48 hours. Vaginal delivery was successful with the intended method in 83% of vacuum-assisted deliveries and in 78% of forceps deliveries (not statistically significant). Neonatal retinal hemorrhage was found in 17 and 38% (P less than .043) of the randomized forceps and vacuum deliveries, respectively. No intraventricular hemorrhage was found. Apart from associations between vacuum-assisted delivery and mild hyperbilirubinemia and neonatal retinal hemorrhage (of uncertain clinical significance), and between assisted forceps delivery and an increased potential for facial injury, neonatal outcomes did not differ significantly. Maternal outcomes also did not differ significantly. No significant differences in safety or efficacy were found between polyethylene cup vacuum extraction and rigid obstetric forceps-assisted vaginal delivery in this population of predominantly low-pelvic assisted deliveries. Patients delivered by sequential use of forceps after vacuum or by vacuum after failed forceps application did not suffer significantly increased morbidity relative to those delivered by forceps or vacuum alone. Use of alternate or sequential methods allowed an overall cesarean rate of 3% in this population.
M C Williams; R A Knuppel; W F O'Brien; A Weiss; K S Kanarek
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  78     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-11-20     Completed Date:  1991-11-20     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  789-94     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of South Florida, Tampa.
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MeSH Terms
Acid-Base Equilibrium
Apgar Score
Birth Injuries / etiology
Cerebral Hemorrhage / etiology
Delivery, Obstetric*
Equipment Design
Fetal Blood / chemistry
Hemoglobins / analysis
Infant, Newborn
Obstetrical Forceps*
Pregnancy Outcome
Prospective Studies
Retinal Hemorrhage / etiology
Vacuum Extraction, Obstetrical / instrumentation*
Reg. No./Substance:
0/Hemoglobins; 0/Polyethylenes
Comment In:
Obstet Gynecol. 1992 Apr;79(4):638-9   [PMID:  1553192 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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