Abstract
BackgroundOperative vaginal delivery is a procedure that is performed using forceps or vacuum to extract an infant from the birth canal. It has many indications, one of which is prolonged second stage of labor. Although rare, vacuum extraction (VE) can lead to various neonatal and maternal complications. The objective of this study was to compare the rates of different neonatal and maternal complications between vacuum-assisted deliveries and spontaneous vaginal deliveries.MethodsThis is a retrospective cohort study that was conducted in King Abdulaziz Medical City, Jeddah (KAMC-J), Saudi Arabia. The data were collected from the Labor and Delivery Unit at KAMC-J. A total of 745 samples was included (586 delivered spontaneously and 157 delivered by VE). Analysis was performed using the Statistical Package for Social Sciences (SPSS) Version 27.0.ResultsThe median age was 30 years (IQR=36-34). Of all deliveries, vacuum was used in 21.1%. Perineal tear was the most frequent maternal complication (20.9%), while caput succedaneum was the commonest neonatal complication (11.8%). Post-partum hemorrhage was significantly higher among vacuum deliveries (RR=18.8; 95% CI: 5.5-64.15), as well as cephalohematoma (RR=28.9; 95% CI: 8.79-95.04) and caput succedaneum (RR=18.6; 95% CI: 10.99-31.49). The first-minute Apgar score was lower with VE (p < 0.001), and higher perineal tear degrees were reported with VE (p < 0.001).ConclusionThe rates of maternal and neonatal complications were significantly higher among vacuum-assisted deliveries. The most serious neonatal complication was subgaleal hematoma, which is considered life-threatening. Further research is recommended to investigate subgaleal hematoma risk factors.
Highlights
Natural birth is a spontaneous process that may or may not run smoothly
Post-partum hemorrhage was significantly higher among vacuum deliveries (RR=18.8; 95% CI: 5.5-64.15), as well as cephalohematoma (RR=28.9; 95% CI: 8.79-95.04) and caput succedaneum (RR=18.6; 95% CI: 10.99-31.49)
The first-minute Apgar score was lower with vacuum extraction (VE) (p < 0.001), and higher perineal tear degrees were reported with VE (p < 0.001)
Summary
Natural birth is a spontaneous process that may or may not run smoothly. In many cases, operative delivery is required for fetal or maternal indications. Institutions greatly rely on the use of a vacuum rather than forceps as an instrument of assisted delivery This method is referred to as vacuum extraction (VE) where a soft or rigid suction cup adheres to the baby's head and aids in the delivery process [1]. VE is highly dependent on the traction resulting from a difference between the atmospheric and suction cup pressure as well as the pressure arising from maternal contractions and bearing down This cumulative pressure facilitates the baby's movement through the birth canal [3]. Operative vaginal delivery is a procedure that is performed using forceps or vacuum to extract an infant from the birth canal It has many indications, one of which is prolonged second stage of labor. The objective of this study was to compare the rates of different neonatal and maternal complications between vacuum-assisted deliveries and spontaneous vaginal deliveries
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