Abstract
BackgroundVaginal delivery, especially operative assisted vaginal delivery, seems to be a major stressor for the neonate. The objective of this study was to evaluate the stress response after metal cup versus Kiwi Omnicup® ventouse delivery.MethodsThe study was a secondary observational analysis of data from a former prospective randomised placebo controlled multicentre study on the analgesic effect of acetaminophen in neonates after operative vaginal delivery and took place at three Swiss tertiary hospitals. Healthy pregnant women ≥35 weeks of gestation with an estimated fetal birth weight above 2000 g were recruited after admission to the labour ward. Pain reaction was analysed by pain expression score EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) directly after delivery. For measurement of the biochemical stress response, salivary cortisol as well as the Bernese Pain Scale of Newborns (BPSN) were evaluated before and after an acute pain stimulus (the standard heel prick for metabolic testing (Guthrie test)) at 48–72 h.ResultsInfants born by vaginal operative delivery displayed a lower pain response after plastic cup than metal cup ventouse delivery (p < 0.001), but the pain response was generally lower than expected and they recovered fully within 72 h.ConclusionsNeonatal pain response is slightly reduced after use of Kiwi OmniCup® versus metal cup ventouse.Trial registrationTrial was registered under under NCT00488540 on 19th June 2007.
Highlights
Vaginal delivery, especially operative assisted vaginal delivery, seems to be a major stressor for the neonate
120 neonates were included in the analysis set, 30 of which were delivered by a rigid plastic cup (Kiwi Omnicup®, Clinical Innovations Inc., Murray, Utah, USA) and 90 by a metal cup ventouse (Menox AB, Göteborg, Sweden) (Fig. 1)
Infants who were delivered by plastic cup did not differ from infants delivered by metal cup ventouse in respect to gestational age, birth weight, length or head circumference, epidural or spinal analgesia, or arterial umbilical cord pH
Summary
Especially operative assisted vaginal delivery, seems to be a major stressor for the neonate. The objective of this study was to evaluate the stress response after metal cup versus Kiwi Omnicup® ventouse delivery. Childbirth and especially the mode of delivery is a major stressor for the neonate. In a previously published study, we showed that neonates born by assisted vaginal delivery in general had the highest burden of pain compared to those delivered by. The metal cup resulted in a non-significantly higher rate of substantial head injuries compared to the use of the Kiwi OmniCup® (38 versus 23%) in one study [7] while another study showed no differences in scalp injury [8]. There is no study examining the pain response after assisted vaginal deliveries using different
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