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https://ciane.net/id=837

Criado em : 08 Jul 2004
Alterado em : 02 Dec 2007

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Nota bibliográfica (sem autor) :

Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis. The British Medical Journal 2004;329:24.

Autores :

Demissie K, Rhoads GG, Smulian JC, Balasubramanian BA, Gandhi K, Joseph KS, Kramer M.

Ano de publicação :

2004

URL(s) :

http://bmj.bmjjournals.com/cgi/content/full/bmj;32…

Résumé (français)  :

Abstract (English)  :

Objective

To compare the risk of neonatal and infant adverse outcomes between vacuum and forceps assisted deliveries.

Design

Population based study.

Setting

US linked natality and mortality birth cohort file and the New Jersey linked natality, mortality, and hospital discharge summary birth cohort file.

Participants

Singleton live births in the United States (n = 11 639 388) and New Jersey (n = 375 351).

Main outcome measures

Neonatal morbidity and mortality.

Results

Neonatal mortality was comparable between vacuum and forceps deliveries in US births (odds ratio 0.94, 95% confidence interval 0.79 to 1.12). Vacuum delivery was associated with a lower risk of birth injuries (0.69, 0.66 to 0.72), neonatal seizures (0.78, 0.68 to 0.90), and need for assisted ventilation (< 30 minutes 0.94, 0.92 to 0.97; 30 minutes 0.92, 0.88 to 0.98). Among births in New Jersey, vacuum extraction was more likely than forceps to be complicated by postpartum haemorrhage (1.22, 1.07 to 1.39) and shoulder dystocia (2.00, 1.62 to 2.48). The risks of intracranial haemorrhage, difficulty with feeding, and retinal haemorrhage were comparable between both modes of delivery. The sequential use of vacuum and forceps was associated with an increased risk of need for mechanical ventilation in the infant and third and fourth degree perineal tears.

Conclusion

Although vacuum extraction does have risks, it remains a safe alternative to forceps delivery.

Sumário (português)  :

Resumen (español)  :

Comentários :

Argument (français) :

Autant de mortalité néonatale avec les forceps et la ventouse.

Argument (English):

Argumento (português):

Argumento (español):

Palavras-chaves :

➡ medicina baseada em evidências ; distocia ; forceps ; ventosa ; hemorragia post-partum ; mortalidade perinatal ; morbidade ; extracção instrumental

Autor da esta ficha :

Cécile Loup — 08 Jul 2004