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Created on : 01 Dec 2017
Modified on : 08 Jan 2018

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Bibliographical entry (without author) :

Perinatal and maternal morbidity and mortality after attempted operative vaginal delivery at midpelvic station, CMAJ 2017 June 5; 189:E764-72

Author(s) :

Giulia M. Muraca, Yasser Sabr, Sarka Lisonkova, Amanda Skoll, Rollin Brant, Geoffrey W. Cundiff and K.S. Joseph

Year of publication :

2017

URL(s) :

http://www.cmaj.ca/content/189/22/E764.full
https://doi.org/10.1503/cmaj.161156

Résumé (français)  :

Abstract (English)  :

Our study showed that attempted midpelvic operative vaginal delivery is associated with substantially higher rates of severe birth trauma and obstetric trauma. Rates of severe perinatal and maternal morbidity and mortality after midpelvic operative vaginal delivery were also increased, although these associations varied by indication and instrument used. Encouraging higher rates of operative vaginal delivery as a strategy to reduce the rate of cesarean delivery could result in increases in severe perinatal and maternal morbidity and mortality, especially birth trauma, severe postpartum hemorrhage and obstetric trauma.

METHODS: We studied all term singleton deliveries in Canada between 2003 and 2013, by attempted midpelvic operative vaginal or cesarean delivery with labour (with and without prolonged second stage). The primary outcomes were composite severe perinatal morbidity and mortality (e.g., convulsions, assisted ventilation, severe birth trauma and perinatal death), and composite severe maternal morbidity and mortality (e.g., severe postpartum hemorrhage, shock, sepsis, cardiac complications, acute renal failure and death).
The study population included 187 234 deliveries.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

l’étude démontre que les extractions en partie moyenne du bassin sont associées à des taux significativement plus élevés de traumatismes foetaux et de traumatismes obstétricaux graves. Tenter de réduire les taux de césarienne par des extractions pourrait donc augmenter la morbidité maternelle et foetale, en particulier les traumatismes de naissance, les hémorragies du post-partum sévères et les traumatismes obstétricaux.

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ c-section/caesarean ; perineal/vaginal tears ; postpartum hemorrhage ; dystocy ; instrumental delivery ; forceps delivery ; vacuum extraction (ventouse) ; morbidity

Author of this record :

Alison Passieux — 01 Dec 2017
➡ latest update : Alison Passieux — 08 Jan 2018